ArticleCritical care (London, England)2022
Impact of dexamethasone on the incidence of ventilator-associated pneumonia in mechanically ventilated COVID-19 patients: a propensity-matched cohort study.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04388670 (Epidemiological and Clinical Characteristics of Patients With COVID-19 Admitted in Italian Intensive Care Units), which is not on this map. Cited by 24 papers.
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.
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.
Epidemiological and Clinical Characteristics of Patients With COVID-19 Admitted in Italian Intensive Care Units: a Multicentric Retrospective-prospective Cohort Study.
Who cites it
24 citing papers in PubMed, 39 citations in OpenAlex.
- Comparative analysis of ventilator-associated pneumonia and ventilator-associated event surveillance systems: a retrospective observational study.Journal of Korean biological nursing science · 2026Article
- Risk factors, predictive biomarkers, and microbial profile of ventilator-associated pneumonia in critically ill patients: a retrospective cohort Study.BMC pulmonary medicine · 2026Article
- Corticosteroids and hospital-acquired pneumonia.Pneumonia (Nathan Qld.) · 2025Review
- Biomarkers trajectories in critically ill patients with COVID-19 acute respiratory distress syndrome: insights from latent class growth analysis.BMC pulmonary medicine · 2025Article
- Early bacterial co-infections and ventilator-associated lower respiratory tract infections among intubated patients during the first and second COVID-19 waves: a European comparative cohort study.Respiratory research · 2025Article
- Corticosteroids in Cardiogenic Shock: A Retrospective Analysis of the Medical Information Mart for Intensive Care-IV Database.Critical care explorations · 2025Article
- Prone position ventilation-induced oxygenation improvement as a valuable predictor of survival in patients with acute respiratory distress syndrome: a retrospective observational study.BMC pulmonary medicine · 2024Observational
- Glucocorticoid therapy for acute respiratory distress syndrome: Current concepts.Journal of intensive medicine · 2024Review
- Incidence and risk factors of ventilator-associated pneumonia in the intensive care unit: a systematic review and meta-analysis.Journal of thoracic disease · 2024Article
- Understanding the burden of antibiotic resistance: a decade of carbapenem-resistant Gram-negative bacterial infections in Italian intensive care units.Frontiers in microbiology · 2024Article
- Incidence, microbiological and immunological characteristics of ventilator-associated pneumonia assessed by bronchoalveolar lavage and endotracheal aspirate in a prospective cohort of COVID-19 patients: CoV-AP study.Critical care (London, England) · 2023Article
- Multidrug-Resistant Bacterial Colonization and Infections in Large Retrospective Cohort of Mechanically Ventilated COVID-19 PatientsEmerging infectious diseases · 2023Article
- Relationship between COVID-19 and ICU-acquired colonization and infection related to multidrug-resistant bacteria: a prospective multicenter before-after study.Intensive care medicine · 2023Observational
- Replicating finding, answering questions: closer to the truth about COVID-19 associated VAP.Critical care (London, England) · 2023Article
- Article
- "Reply on: statistics on steroids-how recognizing competing risks gets us closer to the truth about COVID-19-associated VAP".Critical care (London, England) · 2023Article
- Ventilator associated pneumonia in COVID-19 patients: A retrospective cohort study.Tuberkuloz ve toraks · 2023Observational
- Role of Selective Digestive Decontamination in the Prevention of Ventilator-Associated Pneumonia in COVID-19 Patients: A Pre-Post Observational Study.Journal of clinical medicine · 2023Article
- The impact of COVID-19 on multidrug-resistant organisms causing healthcare-associated infections: a narrative review.JAC-antimicrobial resistance · 2023Review
- Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients.World journal of clinical cases · 2023Article
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo assess the impact of treatment with steroids on the incidence and outcome of ventilator-associated pneumonia (VAP) in mechanically ventilated COVID-19 patients.
designPropensity-matched retrospective cohort study from February 24 to December 31, 2020, in 4 dedicated COVID-19 Intensive Care Units (ICU) in Lombardy (Italy). PATIENTS: Adult consecutive mechanically ventilated COVID-19 patients were subdivided into two groups: (1) treated with low-dose corticosteroids (dexamethasone 6 mg/day intravenous for 10 days) (DEXA+); (2) not treated with corticosteroids (DEXA-). A propensity score matching procedure (1:1 ratio) identified patients' cohorts based on: age, weight, PEEP Level, PaO
interventionDexamethasone 6 mg/day intravenous for 10 days from hospital admission. MEASUREMENTS AND MAIN
resultsSeven hundred and thirty-nine patients were included, and the propensity-score matching identified two groups of 158 subjects each. Eighty-nine (56%) DEXA+ versus 55 (34%) DEXA- patients developed a VAP (RR 1.61 (1.26-2.098), p = 0.0001), after similar time from hospitalization, ICU admission and intubation. DEXA+ patients had higher crude VAP incidence rate (49.58 (49.26-49.91) vs. 31.65 (31.38-31.91)VAP*1000/pd), (IRR 1.57 (1.55-1.58), p < 0.0001) and risk for VAP (HR 1.81 (1.31-2.50), p = 0.0003), with longer ICU LOS and invasive mechanical ventilation but similar mortality (RR 1.17 (0.85-1.63), p = 0.3332). VAPs were similarly due to G+ bacteria (mostly Staphylococcus aureus) and G- bacteria (mostly Enterobacterales). Forty-one (28%) VAPs were due to multi-drug resistant bacteria. VAP was associated with almost doubled ICU and hospital LOS and invasive mechanical ventilation, and increased mortality (RR 1.64 [1.02-2.65], p = 0.040) with no differences among patients' groups.
conclusionsCritically ill COVID-19 patients are at high risk for VAP, frequently caused by multidrug-resistant bacteria, and the risk is increased by corticosteroid treatment.
trial registrationNCT04388670, retrospectively registered May 14, 2020.
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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.