1. Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set
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Conway Morris, Andrew, Kohler, Katharina, De Corte, Thomas, Ercole, Ari, De Grooth, Harm-Jan, Elbers, Paul W G, Povoa, Pedro, Morais, Rui, Koulenti, Despoina, Jog, Sameer, Nielsen, Nathan, Jubb, Alasdair, Cecconi, Maurizio, De Waele, Jan, Marco, Bezzi, Alicia, Gira, Philipp, Eller, Tarikul, Hamid, Injamam Ull Haque, Wim De Buyser, Antonella, Cudia, Daniel De Backer, Pierre, Foulon, Vincent, Collin, Jan De Waele, Jolien Van Hecke, Elisabeth De Waele, Claire Van Malderen, Jean-Baptiste, Mesland, Patrick, Biston, Michael, Piagnerelli, Lionel, Haentjens, Nicolas De Schryver, Jan Van Leemput, Philippe, Vanhove, Pierre, Bulpa, Viktoria, Ilieva, David, Katz, Alexandra, Binnie, Anna, Geagea, Fernando, Tirapegui, Gustavo, Lago, Jerónimo, Graf, Rodrigo, Perez-Araos, Patricio, Vargas, Felipe, Martinez, Eduardo, Labarca, Daniel Molano Franco, Daniela, Parra-Tanoux, Luis Felipe Reyes, David, Yepes, Filip, Periš, Sanda Stojanović Stipić, Cynthia Vanessa Campozano Burgos, Paulo Roberto Navas Boada, Jose Luis Barberan Brun, Juan Pablo Paredes Ballesteros, Gamal, Abdelnasser, Ahmed, Hammouda, Omar, Elmandouh, Ahmed, Azzam, Aliae Mohamed Hussein, Islam, Galal, Ahmed, K Awad, Mohammed, A Azab, Maged, Abdalla, Hebatallah, Assal, Mostafa, Alfishawy, Sherief, Ghozy, Samar, Tharwat, Abdullah, Eldaly, Anneli, Ellervee, Veronika, Reinhard, Anne, Chrisment, Chrystelle, Poyat, Julio, Badie, Fernando Berdaguer Ferrari, Björn, Weiss, Clara, Schellenberg, Julius, J Grunow, Marco, Lorenz, Stefan, J Schaller, Peter, Spieth, Marc, Bota, Falk, Fichtner, Kristina, Fuest, Tobias, Lahmer, Johannes, Herrmann, Patrick, Meybohm, Nikolaos, Markou, Georgia, Vasileiadou, Evangelia, Chrysanthopoulou, Panagiotis, Papamichalis, Ioanna, Soultati, Sameer, Jog, Kushal, Kalvit, Sheila Nainan Myatra, Ivan, Krupa, Aisa, Tharwat, Alistair, Nichol, Aine, Mccarthy, Ata, Mahmoodpoor, Tommaso, Tonetti, Paolo, Isoni, Savino, Spadaro, Carlo Alberto Volta, Lucia, Mirabella, Alberto, Noto, Gaetano, Florio, Amedeo, Guzzardella, Chiara, Paleari, Federica, Baccanelli, Marzia, Savi, Massimo, Antonelli, Gennaro De Pascale, San, Luca, Barbara, Vaccarini, Giorgia, Montrucchio, Gabriele, Sales, Donadello, Katia, Leonardo, Gottin, Marta, Nizzero, Enrico, Polati, De Rosa, Silvia, Demet, Sulemanji, Abdurraouf, Abusalama, Muhammed, Elhadi, Montelongo De FelipeJesus, Daniel Rodriguez Gonzalez, Victor Hugo Madrigal Robles, Nancy, Canedo, Alejandro Esquivel Chavez, Tarek, Dendane, Bart, Grady, Ben de Jong, Eveline van der Heiden, Patrick, Thoral, Bas van den Bogaard, Peter, E Spronk, Sefanja, Achterberg, Melanie, Groeneveld, Ralph K, L So, Calvin de Wijs, Harm, Scholten, Albertus, Beishuizen, Alexander, D Cornet, Auke, C Reidinga, Hetty, Kranen, Roos, Mensink, Spaarne, Gasthuis, Sylvia den Boer, Marcel de Groot, Oliver, Beck, Carina, Bethlehem, Bas van Bussel, Tim, Frenzel, Celestine de Jong, Rob, Wilting, Jozef, Kesecioglu, Jannet, Mehagnoul-Schipper, Datonye, Alasia, Ashok, Kumar, Ahad, Qayyum, Muhammad, Rana, Mustafa Abu Jayyab, Rosario Quispe Sierra, Aaron Mark Hernandez, José de Almeida, Lúcia, Taborda, Mónica, Anselmo, Tiago, Ramires, Catarina, Silva, Carolina, Roriz, Rui, Morais, Pedro, Póvoa, Patricia, Patricio, André, Pinto, Maria Lurdes Santos, Vasco, Costa, Pedro, Cunha, Celina, Gonçalves, Sandra, Nunes, João, Camões, Diana, Adrião, Ana, Oliveira, Ali, Omrani, Muna Al Maslamani, Abdurrahmaan Suei Elbuzidi, Bara Mahmoud Al Qudah, Abdel Rauof Akkari, Mohamed, Alkhatteb, Anas, Baiou, Ahmed, Husain, Mohamed, Alwraidat, Ibrahim Abdulsalam Saif, Dana, Bakdach, Amna, Ahmed, Mohamed, Aleef, Awadh, Bintaher, Cristina, Petrisor, Evgeniy, Popov, Ksenia, Popova, Mariia, Dementienko, Boris, Teplykh, Alexey, Pyregov, Liubov, Davydova, Belskii, Vladislav, Elena, Neporada, Ivan, Zverev, Svetlana, Meshchaninova, Dmitry, Sokolov, Elena, Gavrilova, Irina, Shlyk, Igor, Poliakov, Marina, Vlasova, Ohoud, Aljuhani, Amina, Alkhalaf, Felwa Bin Humaid, Yaseen, Arabi, Ahmed, Kuhail, Omar, Elrabi, Madihah, E Ghannam, Ng Teng Fong, Amit, Kansal, Vui Kian Ho, Jensen, Ng, Raquel Rodrígez García, Xiana Taboada Fraga, Mª Del Pilar García-Bonillo, Antonio, Padilla-Serrano, Marta Martin Cuadrado, Carlos, Ferrando, Ignacio, Catalan-Monzon, Laura, Galarza, Fernando, Frutos-Vivar, Jorge, Jimenez, Carmen, Rodríguez-Solis, Enric, Franquesa-Gonzalez, Guillermo Pérez Acosta, Luciano Santana Cabrera, Juan Pablo Aviles Parra, Francisco Muñoyerro Gonzalez, Maria Del Carmen Lorente Conesa, Ignacio Yago Martinez Varela, Orville Victoriano Baez Pravia, Maria Cruz Martin Delgado, Carlos Munoz de Cabo, Ana-Maria, Ioan, Cesar, Perez-Calvo, Arnoldo, Santos, Ane, Abad-Motos, Javier, Ripolles-Melchor, Belén Civantos Martin, Santiago Yus Teruel, Juan Higuera Lucas, Aaron Blandino Ortiz, Raúl de Pablo Sánchez, Jesús Emilio Barrueco-Francioni, Lorena Forcelledo Espina, José, M Bonell-Goytisolo, Iñigo, Salaverria, Antonia Socias Mir, Emilio, Rodriguez-Ruiz, Virginia Hidalgo Valverde, Patricia Jimeno Cubero, Francisca Arbol Linde, Nieves Cruza Leganes, Juan Maria Romeu, Pablo, Concha, José Angel Berezo-Garcia, Virginia, Fraile, Cristina, Cuenca-Rubio, David, Pérez-Torres, Ainhoa, Serrano, Clara Martínez Valero, Andrea Ortiz Suner, Leire, Larrañaga, Noemi, Legaristi, Gerardo, Ferrigno, Safa, Khlafalla, Rosita, Bihariesingh-Sanchit, Hallands, Sjukhus, Frank, Zoerner, Jonathan, Grip, Kristina, Kilsand, Johan, Mårtensson, Jonas, Österlind, Akademiska, Sjukhuset, Magnus von Seth, Västerviks, Sjukhus, Johan, Berkius, Samuele, Ceruti, Andrea, Glotta, Seval, Izdes, Işıl Özkoçak Turan, Ahmet, Cosar, Burcin, Halacli, Necla, Dereli, Mehmet, Yilmaz, Türkay, Akbas, Gülseren, Elay, Selin, Eyüpoğlu, Yelíz, Bílír, Kemal Tolga Saraçoğlu, Ebru, Kaya, Ayca Sultan Sahin, Pervin Korkmaz Ekren, Tuğçe, Mengi, Kezban Ozmen Suner, Yakup, Tomak, Ahmet, Eroglu, Asad, Alsabbah, Katie, Hanlon, Kevin, Gervin, Sean, Mcmahon, Samantha, Hagan, Caroline, V Higenbottam, Randeep, Mullhi, Lottie, Poulton, Tomasz, Torlinski, Allen, Gareth, Nick, Truman, Gopal, Vijayakumar, Chris, Hall, Alasdair, Jubb, Lenka, Cagova, Nicola, Jones, Sam, Graham, Nicole, Robin, Amanda, Cowton, Adrian, Donnelly, Natalia, Singatullina, Melanie, Kent, Carole, Boulanger, Zoë, Campbell, Elizabeth, Potter, Natalie, Duric, Tamas, Szakmany, Royal, Brompton, Orinta, Kviatkovske, Nandor, Marczin, Caroline, Ellis, Rajnish, Saha, Chunda, Sri-Chandana, John, Allan, Lana, Mumelj, Harish, Venkatesh, Vera Nina Gotz, Anthony, Cochrane, Barbara, Ficial, Shruthi, Kamble, Nuttha, Lumlertgul, Christopher, Oddy, Susan, Jain, Giulia Beatrice Crapelli, Aikaterini, Vlachou, David, Golden, Sweyn, Garrioch, Jeremy, Henning, Gupta, Loveleena, Miriam, Davey, Lina, Grauslyte, Erika, Salciute-Simene, Martin, Cook, Danny, Barling, Phil, Broadhurst, Sarah, Purvis, Michael, Spivey, Benjamin, Shuker, Irina, Grecu, Daniel, Harding, James, T Dean, Nathan, D Nielsen, Sama, Al-Bayati, Mohammed, Al-Sadawi, Mariane, Charron, Peter, Stubenrauch, Jairo, Santanilla, Catherine, Wentowski, Dorothea, Rosenberger, Polikseni, Eksarko, Randeep, Jawa, Intensive care medicine, ACS - Microcirculation, ACS - Diabetes & metabolism, AII - Infectious diseases, Conway Morris, Andrew [0000-0002-3211-3216], Kohler, Katharina [0000-0003-1919-0193], De Corte, Thomas [0000-0001-5011-6640], Ercole, Ari [0000-0001-8350-8093], De Grooth, Harm-Jan [0000-0002-7499-076X], Elbers, Paul WG [0000-0003-0447-6893], Povoa, Pedro [0000-0002-7069-7304], Morais, Rui [0000-0003-4114-6949], Koulenti, Despoina [0000-0003-4364-2612], Jog, Sameer [0000-0002-1134-1260], Nielsen, Nathan [0000-0002-3131-7540], Jubb, Alasdair [0000-0001-5593-866X], Cecconi, Maurizio [0000-0002-4376-6538], De Waele, Jan [0000-0003-1017-9748], Apollo - University of Cambridge Repository, UCL - SSS/DDUV/GECE - Génétique cellulaire, UCL - (SLuc) Service de soins intensifs, Conway Morris A., Kohler K., De Corte T., Ercole A., De Grooth H.-J., Elbers P.W.G., Povoa P., Morais R., Koulenti D., Jog S., Nielsen N., Jubb A., Cecconi M., De Waele J., Bezzi M., Gira A., Eller P., Hamid T., Haque I.U., De Buyser W., Cudia A., De Backer D., Foulon P., Collin V., Van Hecke J., De Waele E., Van Malderen C., Mesland J.-B., Piagnerelli M., Haentjens L., De Schryver N., Van Leemput J., Vanhove P., Bulpa P., Ilieva V., Katz D., Geagea A., Binnie A., Tirapegui F., Lago G., Graf J., Perez-Araos R., Vargas P., Martinez F., Labarca E., Franco D.M., Parra-Tanoux D., Reyes L.F., Yepes D., Peris F., Stipic S.S., Burgos C.V.C., Boada P.R.N., Brun J.L.B., Ballesteros J.P.P., Hammouda A., Elmandouh O., Azzam A., Hussein A.M., Galal I., Awad A.K., Azab M.A., Abdalla M., Assal H., Alfishawy M., Ghozy S., Tharwat S., Eldaly A., Reinhard V., Chrisment A., Poyat C., Badie J., Ferrari F.B., Weiss B., Kuhn K.F., Grunow J.J., Lorenz M., Schaller S., Spieth P., Bota M., Fichtner F., Fuest K., Lahmer T., Herrmann J., Meybohm P., Markou N., Vasileiadou G., Chrysanthopoulou E., Papamichalis P., Soultati I., Kalvit K., Myatra S.N., Krupa I., Tharwat A., Nichol A., McCarthy A., Mahmoodpoor A., Tonetti T., Isoni P., Spadaro S., Volta C.A., Mirabella L., Noto A., Florio G., Guzzardella A., Paleari C., Baccanelli F., Savi M., Antonelli M., Vaccarini B., Montrucchio G., Sales G., Donadello K., Gottin L., Polati E., De Rosa S., Sulemanji D., Abusalama A., Elhadi M., De Jesus M.F., Gonzalez D.R., Canedo N., Chavez A.E., Dendane T., Grady B., de Jong B., van der Heiden E., Thoral P., van den Bogaard B., Spronk P.E., Achterberg S., Groeneveld M., So R.K.L., de Wijs C., Scholten H., Beishuizen A., Cornet A.D., Reidinga A.C., Kranen H., Mensink R., Boer S., de Groot M., Beck O., Bethlehem C., van Bussel B., Frenzel T., de Jong C., Wilting R., Kesecioglu J., Mehagnoul-Schipper J., Alasia D., Kumar A., Qayyum A., Rana M., Jayyab M.A., Sierra R.Q., Hernandez A.M., Taborda L., Ramires T., Silva C., Roriz C., Patricio P., Santos M.L., Costa V., Cunha P., Goncalves C., Nunes S., Camoes J., Adriao D., Oliveira A., Omrani A., Al Maslamani M., elbuzidi A.S., Al qudah B.M., Akkari A.R., Alkhatteb M., Baiou A., Husain A., Alwraidat M., Saif I.A., Bakdach D., Ahmed A., Aleef M., Bintaher A., Petrisor C., Popov E., Popova K., Dementienko M., Teplykh B., Pyregov A., Davydova L., Vladislav B., Neporada E., Zverev I., Meshchaninova S., Sokolov D., Gavrilova E., Shlyk I., Poliakov I., B?aco?a M., Aljuhani O., Alkhalaf A., Humaid F.B., Arabi Y., Kuhail A., Elrabi O., Alghnam M., Kansal A., Ho V.K., Ng J., Garcia R.R., Fraga X.T., del Pilar Garcia-Bonillo M., Padilla-Serrano A., Cuadrado M.M., Ferrando C., Catalan-Monzon I., Galarza L., Frutos-Vivar F., Jimenez J., Rodriguez-Solis C., Franquesa-Gonzalez E., Acosta G.P., Cabrera L.S., Parra J.P.A., Gonzalez F.M., del Carmen Lorente Conesa M., Varela I.Y.M., Pravia O.V.B., Delgado M.C.M., de Cabo C.M., Ioan A.-M., Perez-Calvo C., Santos A., Abad-Motos A., Ripolles-Melchor J., Martin B.C., Teruel S.Y., Lucas J.H., Ortiz A.B., de Pablo Sanchez R., Barrueco-Francioni J.E., Espina L.F., Bonell-Goytisolo J.M., Salaverria I., Mir A.S., Rodriguez-Ruiz E., Valverde V.H., Cubero P.J., Linde F.A., Leganes N.C., Romeu J.M., Concha P., Berezo-Garcia J.A., Fraile V., Cuenca-Rubio C., Perez-Torres D., Serrano A., Valero C.M., Suner A.O., Larranaga L., Legaristi N., Ferrigno G., Khlafalla S., Bihariesingh-Sanchit R., Zoerner F., Grip J., Kilsand K., Osterlind J., von Seth M., Berkius J., Ceruti S., Glotta A., Izdes S., Turan I.O., Cosar A., Halacli B., Dereli N., Yilmaz M., Akbas T., Elay G., Eyupoglu S., Bilir Y., Saracoglu K.T., Kaya E., Sahin A.S., Ekren P.K., Mengi T., Suner K.O., Tomak Y., Eroglu A., Alsabbah A., Hanlon K., Gervin K., McMahon S., Hagan S., Higenbottam C.V., Mullhi R., Poulton L., Torlinski T., Gareth A., Truman N., Vijayakumar G., Hall C., Cagova L., Jones N., Graham S., Robin N., Cowton A., Donnelly A., Singatullina N., Kent M., Boulanger C., Campbell Z., Potter E., Duric N., Szakmany T., Kviatkovske O., Marczin N., Ellis C., Saha R., Sri-Chandana C., Allan J., Mumelj L., Venkatesh H., Gotz V.N., Cochrane A., Lumlertgul N., Ficial B., Jain S., Crapelli G.B., Vlachou A., Golden D., Garrioch S., Henning J., Loveleena G., Davey M., Grauslyte L., Salciute-Simene E., Cook M., Barling D., Broadhurst P., Purvis S., Michael S., Shuker B., Grecu I., Harding D., Dean J.T., Nielsen N.D., Al-Bayati S., Al-Sadawi M., Charron M., Stubenrauch P., Santanilla J., Wentowski C., Rosenberger D., Eksarko P., and Jawa R. more...
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Adult ,Coronavirus Disease 2019 (COVID-19) ,Critical Illness ,Intensive Care Unit ,Pneumonia, Viral ,NCT04836065 ,Adrenal Cortex Hormone ,Critical Care and Intensive Care Medicine ,co-infection ,COVID-19 Testing ,Adrenal Cortex Hormones ,Anti-Bacterial Agent ,Medicine and Health Sciences ,Pneumonia, Bacterial ,Humans ,Pandemics ,Pandemic ,Coinfection ,Research ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,respiratory failure ,COVID-19 ,Anti-Bacterial Agents ,Intensive Care Units ,NCT ,ICU ,Critical Illne ,Coronavirus Disease 2019 (COVID-19), co-infection, ICU, respiratory failure ,Human - Abstract
Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347, BACKGROUND: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients. METHODS: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method. RESULTS: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO. CONCLUSIONS: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)., European Society of Intensive Care Medicine ACM is supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/V006118/1) more...
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- 2022
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