https://doi.org/10.4081/monaldi.2022.2436
Factors predicting mortality among patients with COVID-19 associated hospital acquired pneumonia: insights from a tertiary care center
Submitted: September 23, 2022
Accepted: November 18, 2022
Published: December 14, 2022
Accepted: November 18, 2022
Abstract Views: 2266
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Hospital acquired pneumonia (HAP) is a severe and dangerous complication in patients admitted with COVID-19, causing significant morbidity and mortality globally. However, the early detection and subsequent management of high-risk cases may prevent disease progression and improve clinical outcomes. This study was undertaken in order to identify predictors of mortality in COVID-19 associated HAP. A retrospective study was performed on all patients who were admitted to a tertiary care center with COVID-19 associated HAP from July 2020 till November 2020. Data was collected on relevant demographic, clinical and laboratory parameters to determine their association with in-hospital mortality; 1574 files were reviewed, out of which 162 were included in the final study. The mean age of subjects was 59.4±13.8 and a majority were male (78.4%). There were 71 (48.3%) mortalities in the study sample. Klebsiella pneumoniae (31.5%) and Pseudomonas aeruginosa (30.2%) were the most common organisms overall. Clinically significant growth of Aspergillus sp. was observed in 41 (29.0%) of patients. On univariate analysis, several factors were found to be associated with mortality, including male gender (p=0.04), D-dimers >1.3 mg/L (p<0.001), ferritin >1000 µg/mL (p<0.001), LDH >500I.U/mL (p<0.001) and procalcitonin >2.0 µg/mL (p<0.001). On multivariate analysis, ferritin >1000ng/mL, initial site of care in Special Care Units or Intensive Care Units, developing respiratory failure and developing acute kidney injury were factors independently associated with mortality in our patient sample. These results indicate that serum ferritin levels may be a potentially useful biomarker in the management of COVID-19 associated HAP.
Feldman C, Anderson R. The role of co-infections and secondary infections in patients with COVID-19. Pneumonia 2021;13:1-5.
DOI: https://doi.org/10.1186/s41479-021-00083-w
Scaravilli V, Guzzardella A, Madotto F, et al. Impact of dexamethasone on the incidence of ventilator-associated pneumonia in mechanically ventilated COVID-19 patients: a propensity-matched cohort study. Crit Care 2022;26:1-5.
DOI: https://doi.org/10.1186/s13054-022-04049-2
Rouzé A, Martin-Loeches I, Povoa P, et al. Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study. Intensive Care Med 2021;47:188-98.
DOI: https://doi.org/10.1007/s00134-020-06323-9
Scott H, Zahra A, Fernandes R, et al. Bacterial infections and death among patients with Covid-19 versus non Covid-19 patients with pneumonia. Am J Emerg Med 2022;51:1-5.
Beumer MC, Koch RM, Van Beuningen DR, et al. Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality. J Crit Care 2019;50:59-65.
DOI: https://doi.org/10.1016/j.jcrc.2018.11.013
Jindal HA, Sahoo SS, Jamir LR, et al. Higher coronavirus disease-19 mortality linked to comorbidities: A comparison between low-middle income and high-income countries. J Educ Health Prom 2021;10:377.
Panneer S, Kantamaneni K, Akkayasamy VS, et al. The great lockdown in the wake of COVID-19 and its implications: Lessons for low and middle-income countries. Int J Environ Res Public Health 2022;19:610.
DOI: https://doi.org/10.3390/ijerph19010610
Nasir N, Rehman F, Omair SF. Risk factors for bacterial infections in patients with moderate to severe COVID‐19: A case‐control study. J MediVirol 2021;93:4564-9.
DOI: https://doi.org/10.1002/jmv.27000
Scott H, Zahra A, Fernandes R, et al. Bacterial infections and death among patients with Covid-19 versus non Covid-19 patients with pneumonia. Am J Emerg Med 2022;51:1-5.
DOI: https://doi.org/10.1016/j.ajem.2021.09.040
Garner JS, Jarvis WR, Emori TG, et al. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128-40.
DOI: https://doi.org/10.1016/0196-6553(88)90053-3
Koehler P, Bassetti M, Chakrabarti A, et al. Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. Lancet Infect Dis 2021;21:e149-62.
DOI: https://doi.org/10.1016/S1473-3099(20)30847-1
Ali N, Kapadia NN, Aymen D, Baig N. Utility of biomarkers in predicting complications and in-hospital mortality in patients with COVID-19. Pak J Med Sci 20228;38:1321-6.
DOI: https://doi.org/10.12669/pjms.38.5.5165
Abou Dagher G, Abi Ghanem A, Haidar S, et al. The prognostic value of biomarker levels and chest imaging in patients with COVID-19 presenting to the emergency department. Am J Emerg Med 2022;59:15-23.
DOI: https://doi.org/10.1016/j.ajem.2022.06.043
Hachim IY, Hachim MY, Hannawi H, et al. The inflammatory biomarkers profile of hospitalized patients with COVID-19 and its association with patient’s outcome: A single centered study. Plos One 2021;16:e0260537.
DOI: https://doi.org/10.1371/journal.pone.0260537
Khan M, Shah N, Mushtaq H, Jehanzeb V. Profiling laboratory biomarkers associated with COVID-19 disease progression: A single-center experience. Int J Microbiol 2021;2021:6643333.
DOI: https://doi.org/10.1155/2021/6643333
Maes M, Higginson E, Pereira-Dias J, et al. Ventilator-associated pneumonia in critically ill patients with COVID-19. Crit Care 2021;25:25.
DOI: https://doi.org/10.1186/s13054-021-03460-5
Contou D, Claudinon A, Pajot O, et al. Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU. Ann Intensivs Care 2020;10:119.
DOI: https://doi.org/10.1186/s13613-020-00736-x
Shafran N, Shafran I, Ben-Zvi H, et al. Secondary bacterial infection in COVID-19 patients is a stronger predictor for death compared to influenza patients. Sci Rep 2021;11:12703.
DOI: https://doi.org/10.1038/s41598-021-92220-0
Bardi T, Pintado V, Gomez-Rojo M, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis 2021;40:495-502.
DOI: https://doi.org/10.1007/s10096-020-04142-w
Budhiraja S, Tarai B, Jain D, et al. Secondary infections modify the overall course of hospitalized patients with COVID-19: a retrospective study from a network of hospitals across North India. IJID Regions 2022;3:44-53.
DOI: https://doi.org/10.1016/j.ijregi.2022.02.008
De Santis V, Corona A, Vitale D, et al. Bacterial infections in critically ill patients with SARS-2-COVID-19 infection: results of a prospective observational multicenter study. Infection 2022;50:139-50.
DOI: https://doi.org/10.1007/s15010-021-01661-2
Duszynska W, Idziak M, Smardz K, et al. Frequency, etiology, mortality, cost, and prevention of respiratory tract infections - Prospective, one center study. J Clin Med 2022;11:3764.
DOI: https://doi.org/10.3390/jcm11133764
Bahçe YG, Acer Ö, Özüdoğru O. Evaluation of bacterial agents isolated from endotracheal aspirate cultures of Covid-19 general intensive care patients and their antibiotic resistance profiles compared to pre-pandemic conditions. Microb Pathog 2022;164:105409.
DOI: https://doi.org/10.1016/j.micpath.2022.105409
Alhumaid S, Al Mutair A, Al Alawi Z, et al. Coinfections with bacteria, fungi, and respiratory viruses in patients with SARS-CoV-2: a systematic review and meta-analysis. Pathogens 2021;10:809.
DOI: https://doi.org/10.3390/pathogens10070809
Syed A, Jabeen K, Farooqi J, et al. Invasive pulmonary aspergillosis in critically ill patients with pneumonia due to COVID-19, influenza and community-acquired pneumonia: a prospective observational study. Curr Med Mycol 2022;8:16-24.
Leistner R, Schroeter L, Adam T, et al. Corticosteroids as risk factor for COVID-19-associated pulmonary aspergillosis in intensive care patients. Crit Care 2022;26:30.
DOI: https://doi.org/10.1186/s13054-022-03902-8
How to Cite
Kanwal, Nabila, Humza Thobani, Ainan Arshad, Priya Ashok Kumar, Fatima Amjad, Safia Awan, and Muhammad Irfan. 2022. “Factors Predicting Mortality Among Patients With COVID-19 Associated Hospital Acquired Pneumonia: Insights from a Tertiary Care Center”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2022.2436.
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