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. 2020 Dec 18;24(1):699.
doi: 10.1186/s13054-020-03417-0.

Risks of ventilator-associated pneumonia and invasive pulmonary aspergillosis in patients with viral acute respiratory distress syndrome related or not to Coronavirus 19 disease

Keyvan Razazi  1   2 , Romain Arrestier  3   4 , Anne Fleur Haudebourg  3   4 , Brice Benelli  3   4 , Guillaume Carteaux  3   4   5 , Jean-Winoc Decousser  6   7   8 , Slim Fourati  7 , Paul Louis Woerther  7   8 , Frederic Schlemmer  5   9 , Anais Charles-Nelson  10 , Francoise Botterel #  7   8 , Nicolas de Prost #  3   4   5 , Armand Mekontso Dessap  3   4   5
Affiliations

Risks of ventilator-associated pneumonia and invasive pulmonary aspergillosis in patients with viral acute respiratory distress syndrome related or not to Coronavirus 19 disease

Keyvan Razazi et al. Crit Care. .

Erratum in

Abstract

Background: Data on incidence of ventilator-associated pneumonia (VAP) and invasive pulmonary aspergillosis in patients with severe SARS-CoV-2 infection are limited.

Methods: We conducted a monocenter retrospective study comparing the incidence of VAP and invasive aspergillosis between patients with COVID-19-related acute respiratory distress syndrome (C-ARDS) and those with non-SARS-CoV-2 viral ARDS (NC-ARDS).

Results: We assessed 90 C-ARDS and 82 NC-ARDS patients, who were mechanically ventilated for more than 48 h. At ICU admission, there were significantly fewer bacterial coinfections documented in C-ARDS than in NC-ARDS: 14 (16%) vs 38 (48%), p < 0.01. Conversely, significantly more patients developed at least one VAP episode in C-ARDS as compared with NC-ARDS: 58 (64%) vs. 36 (44%), p = 0.007. The probability of VAP was significantly higher in C-ARDS after adjusting on death and ventilator weaning [sub-hazard ratio = 1.72 (1.14-2.52), p < 0.01]. The incidence of multi-drug-resistant bacteria (MDR)-related VAP was significantly higher in C-ARDS than in NC-ARDS: 21 (23%) vs. 9 (11%), p = 0.03. Carbapenem was more used in C-ARDS than in NC-ARDS: 48 (53%), vs 21 (26%), p < 0.01. According to AspICU algorithm, there were fewer cases of putative aspergillosis in C-ARDS than in NC-ARDS [2 (2%) vs. 12 (15%), p = 0.003], but there was no difference in Aspergillus colonization.

Conclusions: In our experience, we evidenced a higher incidence of VAP and MDR-VAP in C-ARDS than in NC-ARDS and a lower risk for invasive aspergillosis in the former group.

Keywords: ARDS; COVID-19; Invasive aspergillosis; Nosocomial pneumonia; Ventilator-associated pneumonia.

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Conflict of interest statement

All authors report no conflict of interest relevant to this study.

Figures

Fig. 1
Fig. 1
Cumulative probability of ventilator-associated pneumonia (VAP) in C-ARDS (red) and NC-ARDS (blue) patients. For analysis purpose, time from intubation to VAP (continuous line), to death (dotted line), and to weaning (dashed line) were handled as competing risks
See this image and copyright information in PMC

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