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description Publicationkeyboard_double_arrow_right Article , Other literature type , Conference object 2021 ItalyPublisher:Elsevier BV Giacomo Grasselli; Vittorio Scaravilli; Davide Mangioni; Luigia Scudeller; Laura Alagna; Michele Bartoletti; Giacomo Bellani; Emanuela Biagioni; Paolo Bonfanti; N Bottino; Irene Coloretti; SL Cutuli; Gennaro De Pascale; Daniela Ferlicca; Gabriele Fior; Andrea Forastieri; Marco Franzetti; Massimiliano Greco; Amedeo Guzzardella; Sara Linguadoca; Marianna Meschiari; Antonio Messina; Gianpaola Monti; Paola Morelli; Antonio Muscatello; Simone Redaelli; Flavia Stefanini; Tommaso Tonetti; Massimo Antonelli; Maurizio Cecconi; Giuseppe Foti; Roberto Fumagalli; Massimo Girardis; Marco Ranieri; Pierluigi Viale; Mario Carlo Raviglione; Antonio Pesenti; Andrea Gori; Alessandra Bandera;pmc: PMC8056844 , PMC8413726 , PMC8339425 , PMC8413842
handle: 2434/856126 , 2434/899743 , 11585/841318 , 11380/1258710 , 10807/180927
pmc: PMC8056844 , PMC8413726 , PMC8339425 , PMC8413842
handle: 2434/856126 , 2434/899743 , 11585/841318 , 11380/1258710 , 10807/180927
Background: Few small studies have described hospital-acquired infections (HAIs) occurring in patients with COVID-19. Research Question: What characteristics in critically ill patients with COVID-19 are associated with HAIs and how are HAIs associated with outcomes in these patients? Study Design and Methods: Multicenter retrospective analysis of prospectively collected data including adult patients with severe COVID-19 admitted to eight Italian hub hospitals from February 20, 2020, through May 20, 2020. Descriptive statistics and univariate and multivariate Weibull regression models were used to assess incidence, microbial cause, resistance patterns, risk factors (ie, demographics, comorbidities, exposure to medication), and impact on outcomes (ie, ICU discharge, length of ICU and hospital stays, and duration of mechanical ventilation) of microbiologically confirmed HAIs. Results: Of the 774 included patients, 359 patients (46%) demonstrated 759 HAIs (44.7 infections/1,000 ICU patient-days; 35% multidrug-resistant [MDR] bacteria). Ventilator-associated pneumonia (VAP; n = 389 [50%]), bloodstream infections (BSIs; n = 183 [34%]), and catheter-related BSIs (n = 74 [10%]) were the most frequent HAIs, with 26.0 (95% CI, 23.6-28.8) VAPs per 1,000 intubation-days, 11.7 (95% CI, 10.1-13.5) BSIs per 1,000 ICU patient-days, and 4.7 (95% CI, 3.8-5.9) catheter-related BSIs per 1,000 ICU patient-days. Gram-negative bacteria (especially Enterobacterales) and Staphylococcus aureus caused 64% and 28% of cases of VAP, respectively. Variables independently associated with infection were age, positive end expiratory pressure, and treatment with broad-spectrum antibiotics at admission. Two hundred thirty-four patients (30%) died in the ICU (15.3 deaths/1,000 ICU patient-days). Patients with HAIs complicated by septic shock showed an almost doubled mortality rate (52% vs 29%), whereas noncomplicated infections did not affect mortality. HAIs prolonged mechanical ventilation (median, 24 days [interquartile range (IQR), 14-39 days] vs 9 days [IQR, 5-13 days]; P < .001), ICU stay (24 days [IQR, 16-41 days] vs 9 days [IQR, 6-14 days]; P = .003), and hospital stay (42 days [IQR, 25-59 days] vs 23 days [IQR, 13-34 days]; P < .001). Interpretation: Critically ill patients with COVID-19 are at high risk for HAIs, especially VAPs and BSIs resulting from MDR organisms. HAIs prolong mechanical ventilation and hospitalization, and HAIs complicated by septic shock almost double mortality. Trial Registry: ClinicalTrials.gov; No.: NCT04388670; URL: www.clinicaltrials.gov
Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8056844Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413842Data sources: PubMed CentralPubliCatt; CHEST Journal; Archivio Istituzionale della Ricerca dell'Università degli Studi di Milano; Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna; IRIS UNIMORE - Archivio istituzionale della ricerca - Università di Modena e Reggio EmiliaOther literature type . Article . 2021 . Peer-reviewedLicense: Elsevier TDMCHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC8339425Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413726Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.euAccess RoutesGreen bronze 217 citations 217 popularity Top 0.1% influence Top 1% impulse Top 0.1% Powered by BIP!more_vert Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8056844Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413842Data sources: PubMed CentralPubliCatt; CHEST Journal; Archivio Istituzionale della Ricerca dell'Università degli Studi di Milano; Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna; IRIS UNIMORE - Archivio istituzionale della ricerca - Università di Modena e Reggio EmiliaOther literature type . Article . 2021 . Peer-reviewedLicense: Elsevier TDMCHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC8339425Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413726Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1016/j.chest.2021.04.053&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article , Conference object 2021Publisher:American Thoracic Society González, Jessica; Benítez, Iván D.; Carmona, Paola; Santisteve, Sally; Monge, Aida; Moncusí-Moix, Anna; Gort-Paniello, Clara; Pinilla, Lucía; Carratalá, Amara; Zuil, María; Ferrer, Ricard; Ceccato, Adrián; Fernández, Laia; Motos, Ana; Riera, Jordi; Menéndez, Rosario; Garcia-Gasulla, Dario; Peñuelas, Oscar; Bermejo-Martin, Jesús F.; Labarca, Gonzalo; Caballero, Jesus; Torres, Gerard; de Gonzalo-Calvo, David; Torres, Antoni; Barbé, Ferran;Background More than 20% of hospitalized patients with coronavirus disease 2019 (COVID-19) develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. The long-term respiratory sequelae in ICU survivors remain unclear. Research question what are the major long-term pulmonary sequelae in critical COVID-19 survivors? Study Design and Methods Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-minute walking test (6MWT)) and chest computed tomography (CT). Results 125 ICU patients with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%), and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median (IQR) distance in the 6MWT was 400 (362;440) meters. CT scans were abnormal in 70.2% of patients, showing reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT had worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT were age and length of invasive mechanical ventilation during the ICU stay. Interpretation Pulmonary structural abnormalities and functional impairment are highly prevalent in surviving ICU patients with ARDS secondary to COVID-19 3 months after hospital discharge. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months post discharge.
CHEST Journal arrow_drop_down CHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC7930807Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1117&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.euAccess Routesbronze 0 citations 0 popularity Average influence Average impulse Average Powered by BIP!more_vert CHEST Journal arrow_drop_down CHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC7930807Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1117&type=result"></script>'); --> </script>
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description Publicationkeyboard_double_arrow_right Article , Other literature type , Conference object 2021 ItalyPublisher:Elsevier BV Giacomo Grasselli; Vittorio Scaravilli; Davide Mangioni; Luigia Scudeller; Laura Alagna; Michele Bartoletti; Giacomo Bellani; Emanuela Biagioni; Paolo Bonfanti; N Bottino; Irene Coloretti; SL Cutuli; Gennaro De Pascale; Daniela Ferlicca; Gabriele Fior; Andrea Forastieri; Marco Franzetti; Massimiliano Greco; Amedeo Guzzardella; Sara Linguadoca; Marianna Meschiari; Antonio Messina; Gianpaola Monti; Paola Morelli; Antonio Muscatello; Simone Redaelli; Flavia Stefanini; Tommaso Tonetti; Massimo Antonelli; Maurizio Cecconi; Giuseppe Foti; Roberto Fumagalli; Massimo Girardis; Marco Ranieri; Pierluigi Viale; Mario Carlo Raviglione; Antonio Pesenti; Andrea Gori; Alessandra Bandera;pmc: PMC8056844 , PMC8413726 , PMC8339425 , PMC8413842
handle: 2434/856126 , 2434/899743 , 11585/841318 , 11380/1258710 , 10807/180927
pmc: PMC8056844 , PMC8413726 , PMC8339425 , PMC8413842
handle: 2434/856126 , 2434/899743 , 11585/841318 , 11380/1258710 , 10807/180927
Background: Few small studies have described hospital-acquired infections (HAIs) occurring in patients with COVID-19. Research Question: What characteristics in critically ill patients with COVID-19 are associated with HAIs and how are HAIs associated with outcomes in these patients? Study Design and Methods: Multicenter retrospective analysis of prospectively collected data including adult patients with severe COVID-19 admitted to eight Italian hub hospitals from February 20, 2020, through May 20, 2020. Descriptive statistics and univariate and multivariate Weibull regression models were used to assess incidence, microbial cause, resistance patterns, risk factors (ie, demographics, comorbidities, exposure to medication), and impact on outcomes (ie, ICU discharge, length of ICU and hospital stays, and duration of mechanical ventilation) of microbiologically confirmed HAIs. Results: Of the 774 included patients, 359 patients (46%) demonstrated 759 HAIs (44.7 infections/1,000 ICU patient-days; 35% multidrug-resistant [MDR] bacteria). Ventilator-associated pneumonia (VAP; n = 389 [50%]), bloodstream infections (BSIs; n = 183 [34%]), and catheter-related BSIs (n = 74 [10%]) were the most frequent HAIs, with 26.0 (95% CI, 23.6-28.8) VAPs per 1,000 intubation-days, 11.7 (95% CI, 10.1-13.5) BSIs per 1,000 ICU patient-days, and 4.7 (95% CI, 3.8-5.9) catheter-related BSIs per 1,000 ICU patient-days. Gram-negative bacteria (especially Enterobacterales) and Staphylococcus aureus caused 64% and 28% of cases of VAP, respectively. Variables independently associated with infection were age, positive end expiratory pressure, and treatment with broad-spectrum antibiotics at admission. Two hundred thirty-four patients (30%) died in the ICU (15.3 deaths/1,000 ICU patient-days). Patients with HAIs complicated by septic shock showed an almost doubled mortality rate (52% vs 29%), whereas noncomplicated infections did not affect mortality. HAIs prolonged mechanical ventilation (median, 24 days [interquartile range (IQR), 14-39 days] vs 9 days [IQR, 5-13 days]; P < .001), ICU stay (24 days [IQR, 16-41 days] vs 9 days [IQR, 6-14 days]; P = .003), and hospital stay (42 days [IQR, 25-59 days] vs 23 days [IQR, 13-34 days]; P < .001). Interpretation: Critically ill patients with COVID-19 are at high risk for HAIs, especially VAPs and BSIs resulting from MDR organisms. HAIs prolong mechanical ventilation and hospitalization, and HAIs complicated by septic shock almost double mortality. Trial Registry: ClinicalTrials.gov; No.: NCT04388670; URL: www.clinicaltrials.gov
Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8056844Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413842Data sources: PubMed CentralPubliCatt; CHEST Journal; Archivio Istituzionale della Ricerca dell'Università degli Studi di Milano; Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna; IRIS UNIMORE - Archivio istituzionale della ricerca - Università di Modena e Reggio EmiliaOther literature type . Article . 2021 . Peer-reviewedLicense: Elsevier TDMCHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC8339425Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413726Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1016/j.chest.2021.04.053&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.euAccess RoutesGreen bronze 217 citations 217 popularity Top 0.1% influence Top 1% impulse Top 0.1% Powered by BIP!more_vert Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8056844Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413842Data sources: PubMed CentralPubliCatt; CHEST Journal; Archivio Istituzionale della Ricerca dell'Università degli Studi di Milano; Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna; IRIS UNIMORE - Archivio istituzionale della ricerca - Università di Modena e Reggio EmiliaOther literature type . Article . 2021 . Peer-reviewedLicense: Elsevier TDMCHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC8339425Data sources: PubMed CentralEurope PubMed CentralArticle . 2021Full-Text: http://europepmc.org/articles/PMC8413726Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1016/j.chest.2021.04.053&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article , Conference object 2021Publisher:American Thoracic Society González, Jessica; Benítez, Iván D.; Carmona, Paola; Santisteve, Sally; Monge, Aida; Moncusí-Moix, Anna; Gort-Paniello, Clara; Pinilla, Lucía; Carratalá, Amara; Zuil, María; Ferrer, Ricard; Ceccato, Adrián; Fernández, Laia; Motos, Ana; Riera, Jordi; Menéndez, Rosario; Garcia-Gasulla, Dario; Peñuelas, Oscar; Bermejo-Martin, Jesús F.; Labarca, Gonzalo; Caballero, Jesus; Torres, Gerard; de Gonzalo-Calvo, David; Torres, Antoni; Barbé, Ferran;Background More than 20% of hospitalized patients with coronavirus disease 2019 (COVID-19) develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. The long-term respiratory sequelae in ICU survivors remain unclear. Research question what are the major long-term pulmonary sequelae in critical COVID-19 survivors? Study Design and Methods Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-minute walking test (6MWT)) and chest computed tomography (CT). Results 125 ICU patients with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%), and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median (IQR) distance in the 6MWT was 400 (362;440) meters. CT scans were abnormal in 70.2% of patients, showing reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT had worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT were age and length of invasive mechanical ventilation during the ICU stay. Interpretation Pulmonary structural abnormalities and functional impairment are highly prevalent in surviving ICU patients with ARDS secondary to COVID-19 3 months after hospital discharge. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months post discharge.
CHEST Journal arrow_drop_down CHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC7930807Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1117&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.euAccess Routesbronze 0 citations 0 popularity Average influence Average impulse Average Powered by BIP!more_vert CHEST Journal arrow_drop_down CHEST JournalArticle . 2021Full-Text: http://europepmc.org/articles/PMC7930807Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1117&type=result"></script>'); --> </script>
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