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Trecarichi EM, Olivadese V, Davoli C, Rotundo S, Serapide F, Lionello R, Tassone B, La Gamba V, Fusco P, Russo A, Borelli M, Torti C. Evolution of in-hospital patient characteristics and predictors of death in the COVID-19 pandemic across four waves: are they moving targets with implications for patient care? Front Public Health 2024; 11:1280835. [PMID: 38249374 PMCID: PMC10800172 DOI: 10.3389/fpubh.2023.1280835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives The aim of this work was to study characteristics, outcomes and predictors of all-cause death in inpatients with SARS-CoV-2 infection across the pandemic waves in one large teaching hospital in Italy to optimize disease management. Methods All patients with SARS-CoV-2 infection admitted to our center from March 2020 to June 2022 were included in this retrospective observational cohort study. Both descriptive and regression tree analyses were applied to identify factors influencing all-cause mortality. Results 527 patients were included in the study (65.3% with moderate and 34.7% with severe COVID-19). Significant evolutions of patient characteristics were found, and mortality increased in the last wave with respect to the third wave notwithstanding vaccination. Regression tree analysis showed that in-patients with severe COVID-19 had the greatest mortality across all waves, especially the older adults, while prognosis depended on the pandemic waves in patients with moderate COVID-19: during the first wave, dyspnea was the main predictor, while chronic kidney disease emerged as determinant factor afterwards. Conclusion Patients with severe COVID-19, especially the older adults during all waves, as well as those with moderate COVID-19 and concomitant chronic kidney disease during the most recent waves require more attention for monitoring and care. Therefore, our study drives attention towards the importance of co-morbidities and their clinical impact in patients with COVID-19 admitted to hospital, indicating that the healthcare system should adapt to the evolving features of the epidemic.
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Affiliation(s)
- Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Vincenzo Olivadese
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Chiara Davoli
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Rosaria Lionello
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Bruno Tassone
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Valentina La Gamba
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Massimo Borelli
- UMG School of PhD Programmes "Life Sciences and Technologies", “Magna Graecia” University, Catanzaro, Italy
| | - Carlo Torti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy
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Rotundo S, Borelli M, Scaglione V, Lionello R, Biamonte F, Olivadese V, Quirino A, Morrone HL, Matera G, Costanzo FS, Russo A, Trecarichi EM, Torti C. Interleukin-6 2/lymphocyte as a proposed predictive index for COVID-19 patients treated with monoclonal antibodies. Clin Exp Med 2023; 23:3681-3687. [PMID: 37097384 PMCID: PMC10127195 DOI: 10.1007/s10238-023-01081-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
In a convenience sample of 93 patients treated with monoclonal antibodies (moAbs) against SARS-CoV-2, the interleukin-62/lymphocyte count ratio (IL-62/LC) was able to predict clinical worsening both in early stages of COVID-19 and in oxygen-requiring patients. Moreover, we analysed 18 most at-risk patients with asymptomatic or mild disease treated with both moAbs and antiviral treatment and found that only 2 had clinical progression, while patients with a similar risk were reported to have an unfavourable outcome in most cases from recent data. In only one of our 18 patients, clinical progression was attributable to COVID-19, and in the other cases, clinical progression was observed despite IL-62/LC being above the risk cut-off. In conclusion, IL-62/LC may be a valuable method to identify patients requiring more aggressive treatments both in earlier and later stages of the disease; however, most at-risk patients can be protected from clinical worsening by combining moAbs and antivirals, even if levels of the IL-62/LC biomarker are lower than the risk cut-off.
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Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy.
| | - Massimo Borelli
- UMG School of PhD Programmes, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Scaglione
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Rosaria Lionello
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Flavia Biamonte
- Department of Clinical and Experimental Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Olivadese
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Alessandro Russo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Carlo Torti
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
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Quirino A, Marascio N, Scarlata GGM, Cicino C, Pavia G, Pantanella M, Carlisi G, Mercurio M, Familiari F, Rotundo S, Olivadese V, La Gamba V, Serapide F, Gasparini G, Matera G. Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12123224. [PMID: 36553231 PMCID: PMC9778170 DOI: 10.3390/diagnostics12123224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Orthopedic and trauma device-related infections (ODRI) due to high virulence microorganisms are a devastating complication after orthopedic surgery. Coagulase-negative Staphylococci (CoNS) are mainly involved but commensal bacteria, located in human mucous membranes, are emerging pathogens in ODRI. Currently, bacterial culture is the gold standard for ODRI but the diagnostic process remains time consuming and laborious. We evaluated a combination of microbiological approaches in the diagnosis of emerging pathogens involved in ODRI. We analyzed two synovial fluids, five tissue samples and five surgical wound swabs from two different patients with ODRI, attending the Department of Orthopedic and Trauma Surgery of Mater Domini Teaching Hospital, Catanzaro, Italy. Identification was carried out with a combination of microbiological approaches (culture, mass spectrometry and 16s rRNA gene sequencing). We demonstrated the importance of a combination of microbiological approaches for the diagnosis of emerging pathogens in ODRI, because the low number of cases in the literature makes it very difficult to formulate guidelines for the management of patients.
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Affiliation(s)
- Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
- Correspondence:
| | | | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Grazia Pavia
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Marta Pantanella
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giovanni Carlisi
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Michele Mercurio
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Filippo Familiari
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Salvatore Rotundo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Vincenzo Olivadese
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Valentina La Gamba
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giorgio Gasparini
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
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Scaglione V, Rotundo S, Marascio N, De Marco C, Lionello R, Veneziano C, Berardelli L, Quirino A, Olivadese V, Serapide F, Tassone B, Morrone HL, Davoli C, La Gamba V, Bruni A, Cesana BM, Matera G, Russo A, Costanzo FS, Viglietto G, Trecarichi EM, Torti C, Russo A, Serapide F, Tassone B, Fusco P, Scaglione V, Davoli C, Lionello R, Gamba VL, Rotundo S, Morrone H, Berardelli L, Tassone MT, Olivadese V, Serraino R, Costa C, Alcaro S, Filippo CD, Sarro GD, Pujia A, Quattrone A, Costanzo FS, Cuda G, Foti DP, Viglietto G, Matera G, Longhini F, Bruni A, Garofalo E, Biamonte E, Brescia V, Laganà D, Petullà M, Bertucci B, Quirino A, Barreca GS, Giancotti A, Gallo L, Lamberti A, Marascio N, Francesco AED, Mirarchi S, Torti C. Publisher Correction: Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study. BMC Infect Dis 2022; 22:883. [PMID: 36434528 PMCID: PMC9700875 DOI: 10.1186/s12879-022-07871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Vincenzo Scaglione
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Salvatore Rotundo
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Nadia Marascio
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Carmela De Marco
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Rosaria Lionello
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Claudia Veneziano
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Lavinia Berardelli
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Angela Quirino
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Vincenzo Olivadese
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Francesca Serapide
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Bruno Tassone
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Helen Linda Morrone
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Chiara Davoli
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Valentina La Gamba
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Andrea Bruni
- grid.411489.10000 0001 2168 2547Chair of Intensive Care, Department of Medical and Surgical Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Bruno Mario Cesana
- grid.4708.b0000 0004 1757 2822Unit of Medical Statistics, Biometrics and Bioinformatics “Giulio A. Maccacaro”, Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Matera
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Alessandro Russo
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Francesco Saverio Costanzo
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University, Catanzaro, Italy
| | - Giuseppe Viglietto
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Carlo Torti
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
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Scaglione V, Rotundo S, Marascio N, De Marco C, Lionello R, Veneziano C, Berardelli L, Quirino A, Olivadese V, Serapide F, Tassone B, Morrone HL, Davoli C, La Gamba V, Bruni A, Cesana BM, Matera G, Russo A, Costanzo FS, Viglietto G, Trecarichi EM, Torti C. Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study. BMC Infect Dis 2022; 22:793. [PMID: 36266619 PMCID: PMC9583059 DOI: 10.1186/s12879-022-07774-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Monoclonal antibodies (mAbs) and antivirals have been approved for early therapy of coronavirus disease (COVID-19), however, in the real-life setting, there are difficulties to prescribe these therapies within few days from symptom onset as recommended, and effectiveness of combined use of these drugs have been hypothesised in most-at-risk patients (such as those immunocompromised) but data supporting this strategy are limited. Methods We describe the real-life experience of SARS-CoV-2 antivirals and/or monoclonal antibodies (mAbs) and focus on the hospitalisation rate due to the progression of COVID-19. Clinical results obtained through our risk-stratification algorithm and benefits achieved through a strategic proximity territorial centre are provided. We also report a case series with an in-depth evaluation of SARS-CoV-2 genome in relationship with treatment strategy and clinical evolution of patients. Results Two hundred eighty-eight patients were analysed; 94/288 (32.6%) patients were treated with mAb monotherapy, 171/288 (59.4%) patients were treated with antivirals, and 23/288 (8%) patients received both mAbs and one antiviral drug. Haematological malignancies were more frequent in patients treated with combination therapy than in the other groups (p = 0.0003). There was a substantial increase in the number of treated patients since the opening of the centre dedicated to early therapies for COVID-19. The provided disease-management and treatment appeared to be effective since 98.6% patients recovered without hospital admission. Moreover, combination therapy with mAbs and antivirals seemed successful because all patients admitted to the hospital for COVID-19 did not receive such therapies, while none of the most-at-risk patients treated with combination therapy were hospitalized or reported adverse events. Conclusions A low rate of COVID-19 progression requiring hospital admission was observed in patients included in this study. The dedicated COVID-19 proximity territorial service appeared to strengthen the regional sanitary system, avoiding the overwhelming of other services. Importantly, our results also support early combination therapy: it is possible that this strategy reduces the emergence of escape mutants of SARS-CoV-2, thereby increasing efficacy of early treatment, especially in immunocompromised individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07774-9.
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Affiliation(s)
- Vincenzo Scaglione
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Salvatore Rotundo
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Nadia Marascio
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Carmela De Marco
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Rosaria Lionello
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Claudia Veneziano
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Lavinia Berardelli
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Angela Quirino
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Vincenzo Olivadese
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Francesca Serapide
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Bruno Tassone
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Helen Linda Morrone
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Chiara Davoli
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Valentina La Gamba
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Andrea Bruni
- Chair of Intensive Care, Department of Medical and Surgical Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Bruno Mario Cesana
- Unit of Medical Statistics, Biometrics and Bioinformatics "Giulio A. Maccacaro", Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Matera
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Alessandro Russo
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Carlo Torti
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy.
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Russo A, Olivadese V, Trecarichi EM, Torti C. Bacterial Ventilator-Associated Pneumonia in COVID-19 Patients: Data from the Second and Third Waves of the Pandemic. J Clin Med 2022; 11:jcm11092279. [PMID: 35566405 PMCID: PMC9100863 DOI: 10.3390/jcm11092279] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, many patients requiring invasive mechanical ventilation were admitted to intensive care units (ICU) for COVID-19-related severe respiratory failure. As a matter of fact, ICU admission and invasive ventilation increased the risk of ventilator-associated pneumonia (VAP), which is associated with high mortality rate and a considerable burden on length of ICU stay and healthcare costs. The objective of this review was to evaluate data about VAP in COVID-19 patients admitted to ICU that developed VAP, including their etiology (limiting to bacteria), clinical characteristics, and outcomes. The analysis was limited to the most recent waves of the epidemic. The main conclusions of this review are the following: (i) P. aeruginosa, Enterobacterales, and S. aureus are more frequently involved as etiology of VAP; (ii) obesity is an important risk factor for the development of VAP; and (iii) data are still scarce and increasing efforts should be put in place to optimize the clinical management and preventative strategies for this complex and life-threatening disease.
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