ArticleCritical care (London, England)2022
Early steroids and ventilator-associated pneumonia in COVID-19-related ARDS.
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. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Efficacy of corticosteroids in patients with acute respiratory distress syndrome: a meta-analysis.Annals of medicine · 2024Pooled it
- Comparative analysis of ventilator-associated pneumonia and ventilator-associated event surveillance systems: a retrospective observational study.Journal of Korean biological nursing science · 2026Article
- Engineering Resatorvid-Loaded Sub-Microgels of Epigallocatechin-3-gallate/Hyaluronic Acid to Treat Acute Lung Injury.Advanced healthcare materials · 2026Article
- Time-varying associations between corticosteroid dose and hospital mortality in ARDS: a sliding-window analysis of MIMIC-IV.BMC pulmonary medicine · 2026Observational
- Induced Regulatory T Cells Attenuate Poly I:C-Triggered Acute Lung Injury by Modulating Cytokine Responses.Journal of immunology research · 2026Article
- Corticosteroids and hospital-acquired pneumonia.Pneumonia (Nathan Qld.) · 2025Review
- Prognostic Factors in COVID-19 Patients with Ventilator-Associated Pneumonia: A Single-Centre Experience.Infectious diseases & clinical microbiology · 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
- Glucocorticoid therapy for acute respiratory distress syndrome: Current concepts.Journal of intensive medicine · 2024Review
- Relationship between SARS-CoV-2 infection and ICU-acquired candidemia in critically ill medical patients: a multicenter prospective cohort study.Critical care (London, England) · 2024Article
- Article
- Nanotherapy therapy for acute respiratory distress syndrome: a review.Frontiers in medicine · 2024Review
- Article
- ICU-Acquired Colonization and Infection Related to Multidrug-Resistant Bacteria in COVID-19 Patients: A Narrative Review.Antibiotics (Basel, Switzerland) · 2023Review
- Clinical and Microbiological Outcomes and Follow-Up of Secondary Bacterial and Fungal Infections among Critically Ill COVID-19 Adult Patients Treated with and without Immunomodulation: A Prospective Cohort Study.Antibiotics (Basel, Switzerland) · 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
- Anticoagulation strategy and safety in critically ill COVID-19 patients: a French retrospective multicentre study.Thrombosis journal · 2023Article
- Is COVID-19 different from other causes of acute respiratory distress syndrome?Journal of intensive medicine · 2023Review
Corrections and comments
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Authors and funding
22 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleEarly corticosteroid treatment is used to treat COVID-19-related acute respiratory distress syndrome (ARDS). Infection is a well-documented adverse effect of corticosteroid therapy.
objectivesTo determine whether early corticosteroid therapy to treat COVID-19 ARDS was associated with ventilator-associated pneumonia (VAP).
methodsWe retrospectively included adults with COVID-19-ARDS requiring invasive mechanical ventilation (MV) for ≥ 48 h at any of 15 intensive care units in 2020. We divided the patients into two groups based on whether they did or did not receive corticosteroids within 24 h. The primary outcome was VAP incidence, with death and extubation as competing events. Secondary outcomes were day 90-mortality, MV duration, other organ dysfunctions, and VAP characteristics. MEASUREMENTS AND MAIN
resultsOf 670 patients (mean age, 65 years), 369 did and 301 did not receive early corticosteroids. The cumulative VAP incidence was higher with early corticosteroids (adjusted hazard ratio [aHR] 1.29; 95% confidence interval [95% CI] 1.05-1.58; P = 0.016). Antibiotic resistance of VAP bacteria was not different between the two groups (odds ratio 0.94, 95% CI 0.58-1.53; P = 0.81). 90-day mortality was 30.9% with and 24.3% without early corticosteroids, a nonsignificant difference after adjustment on age, SOFA score, and VAP occurrence (aHR 1.15; 95% CI 0.83-1.60; P = 0.411). VAP was associated with higher 90-day mortality (aHR 1.86; 95% CI 1.33-2.61; P = 0.0003).
conclusionsEarly corticosteroid treatment was associated with VAP in patients with COVID-19-ARDS. Although VAP was associated with higher 90-day mortality, early corticosteroid treatment was not. Longitudinal randomized controlled trials of early corticosteroids in COVID-19-ARDS requiring MV are warranted.
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