Evidence map›Paper›PMID 33430915›Full record

Observational studyCritical care (London, England)2021

Ventilator-associated pneumonia in critically ill patients with COVID-19.

Mailis Maes, Ellen Higginson, Joana Pereira-Dias, Martin D Curran, Surendra Parmar, Fahad Khokhar, Delphine Cuchet-Lourenço, Janine Lux, Sapna Sharma-Hajela, Benjamin Ravenhill and 12 more

Erratum issuedOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 165 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
165citing papers in PubMed, 5 pooled it
45.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

165 citing papers in PubMed, 5 syntheses or guidelines pooled it, 326 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Review
  8. Observational
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article

105 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors at 3 institutions in 1 country.

Mailis Maes *Department of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Ellen Higginson *Department of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Joana Pereira-Dias *Department of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Martin D CurranPublic Health England, Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
Surendra ParmarPublic Health England, Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
Fahad KhokharDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Delphine Cuchet-LourençoDivision of Anaesthesia, Department of Medicine, University of Cambridge, Level 4, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
Janine LuxDivision of Anaesthesia, Department of Medicine, University of Cambridge, Level 4, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
Sapna Sharma-HajelaJohn Farman ICU, Addenbrookes Hospital, Cambridge, UK.
Benjamin RavenhillJohn Farman ICU, Addenbrookes Hospital, Cambridge, UK.
Islam HamedJohn Farman ICU, Addenbrookes Hospital, Cambridge, UK.
Laura HealesJohn Farman ICU, Addenbrookes Hospital, Cambridge, UK.
Razeen MahroofJohn Farman ICU, Addenbrookes Hospital, Cambridge, UK.
Amelia SoderholmDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Sally ForrestDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Sushmita SridharDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Nicholas M BrownPublic Health England, Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
Stephen BakerDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Vilas NavapurkarJohn Farman ICU, Addenbrookes Hospital, Cambridge, UK.
Gordon DouganDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Josefin Bartholdson ScottDepartment of Medicine, Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK.
Andrew Conway MorrisDivision of Anaesthesia, Department of Medicine, University of Cambridge, Level 4, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK. ac926@cam.ac.uk.ORCID http://orcid.org/0000-0002-3211-3216
University of Cambridge · GBAddenbrooke's Hospital · GBPublic Health England · GB

Funding

Wellcome TrustWellcome Trust WT 2055214/Z/16/Z
6 · The paper itself

Abstract

backgroundPandemic COVID-19 caused by the coronavirus SARS-CoV-2 has a high incidence of patients with severe acute respiratory syndrome (SARS). Many of these patients require admission to an intensive care unit (ICU) for invasive ventilation and are at significant risk of developing a secondary, ventilator-associated pneumonia (VAP).

objectivesTo study the incidence of VAP and bacterial lung microbiome composition of ventilated COVID-19 and non-COVID-19 patients.

methodsIn this retrospective observational study, we compared the incidence of VAP and secondary infections using a combination of microbial culture and a TaqMan multi-pathogen array. In addition, we determined the lung microbiome composition using 16S RNA analysis in a subset of samples. The study involved 81 COVID-19 and 144 non-COVID-19 patients receiving invasive ventilation in a single University teaching hospital between March 15th 2020 and August 30th 2020.

resultsCOVID-19 patients were significantly more likely to develop VAP than patients without COVID (Cox proportional hazard ratio 2.01 95% CI 1.14-3.54, p = 0.0015) with an incidence density of 28/1000 ventilator days versus 13/1000 for patients without COVID (p = 0.009). Although the distribution of organisms causing VAP was similar between the two groups, and the pulmonary microbiome was similar, we identified 3 cases of invasive aspergillosis amongst the patients with COVID-19 but none in the non-COVID-19 cohort. Herpesvirade activation was also numerically more frequent amongst patients with COVID-19.

conclusionCOVID-19 is associated with an increased risk of VAP, which is not fully explained by the prolonged duration of ventilation. The pulmonary dysbiosis caused by COVID-19, and the causative organisms of secondary pneumonia observed are similar to that seen in critically ill patients ventilated for other reasons.

Indexed as

AgedCOVID-19Critical IllnessFemaleHumansIntensive Care UnitsMaleMiddle AgedPneumonia, Ventilator-AssociatedRetrospective StudiesCOVID-19Critical careMolecular diagnosticsNosocomial infectionsSARS-CoV-2Ventilator-associated pneumonia

Identifiers

PMID33430915
PMCPMC7797892
OpenAlexW3119007350

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.