1. Positive airway pressure longer than 24 h is associated with histopathological volutrauma in severe COVID-19 pneumonia—an ESGFOR based narrative case-control review
- Author
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Veroniek Saegeman, Marta C. Cohen, Lydia Abasolo, Jordi Rello, Benjamin Fernandez-Gutierrez, Amparo Fernandez-Rodriguez, Institut Català de la Salut, [Saegeman V] Department of Microbiology and Infection Control, Vitaz, Sint-Niklaas, Belgium. Department of Infection Control, University Hospitals, Leuven, Belgium. [Cohen MC] Histopathology Department, Sheffield Children’s NHS FT, Sheffield, UK. [Abasolo L] Rheumatology Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IDISSC), Hospital Clínico San Carlos, Madrid, Spain. [Rello J] Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia (CRIPS), Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. Clinical Research, CHRU Nimes, Nimes, France. [Fernandez-Gutierrez B] Rheumatology Department, Hospital Clinico San Carlos, Madrid, Spain. [Fernandez-Rodriguez A] Microbiology Laboratory, Biology Department, Instituto Nacional de Toxicología y Ciencias Forenses, Las Rozas de Madrid, Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Therapeutics::Airway Management::Respiration, Artificial [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Pneumònia vírica ,terapéutica::manejo de la via aérea::respiración artificial [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,enfermedades respiratorias::enfermedades pulmonares::neumonía [ENFERMEDADES] ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,General Medicine ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,Respiració artificial - Complicacions ,Respiratory Tract Diseases::Lung Diseases::Pneumonia [DISEASES] ,COVID-19 (Malaltia) - Complicacions - Abstract
SARS-CoV-2; Post-mortem microbiology; Volutrauma SARS-CoV-2; Microbiología post mortem; Volutrauma SARS-CoV-2; Microbiologia post mortem; Volutrauma Background and Objective: A thorough understanding of the pathogenic mechanisms elicited by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still requires further research. Until recently, only a restricted number of autopsies have been performed, therefore limiting the accurate knowledge of the lung injury associated with SARS-CoV-2. A multidisciplinary European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group of Forensic and Post-mortem Microbiology-ESGFOR team conducted a non-systematic narrative literature review among coronavirus 2019 disease (COVID-19) pneumonia cases assessing the histopathological (HP) effects of positive airways pressure. HP lung features were recorded and compared between mechanically ventilated (>24 hours) and control (ventilation 24 hours as an independent variable associated with DAD (OR =5.40, 95% CI: 1.48–19.62), fibrosis (OR =3.88, 95% CI: 1.25–12.08), vascular damage (OR =5.49, 95% CI: 1.78–16.95) and association of DAD plus fibrosis plus vascular damage (OR =6.99, 95% CI: 2.04–23.97). Conclusions: We identified that patients mechanically ventilated >24 hours had a significantly higher rate of pulmonary injury on histopathology independently of age and gender. Our findings emphasize the importance of maintaining a protective ventilator strategy when subjects with COVID-19 pneumonia undergo intubation.
- Published
- 2022