Ventilator-Associated Pneumonia in COVID-19 Patients: Prevalence and Associated Factors

Mahdi  Bozorgi; Mohammad Javad  Azadchehr; Saina  Najafi; Najmeh  Sedighimehr; Javad  Fathi; Hamed  Pahlevani; Maedeh  Najafizadeh

doi:10.18502/jmb.v13i2.18657

Mahdi Bozorgi Department of Infectious Diseases, Kashan School of Medicine, Kashan University of Medical Sciences Kashan Iran.
Mohammad Javad Azadchehr Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
Saina Najafi Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Najmeh Sedighimehr Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Javad Fathi Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
Hamed Pahlevani Department of Anesthesiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran.
Maedeh Najafizadeh Department of Infectious Diseases, Kashan School of Medicine, Kashan University of Medical Sciences Kashan Iran.

DOI: https://doi.org/10.18502/jmb.v13i2.18657

Keywords: COVID-19, Intensive care unit (ICU), Inflammation, Mechanical ventilation, Risk factors, Ventilator- associated pneumonia (VAP).

Abstract

Background: COVID 19 pandemic has resulted in increased ICU admission, with many patientsrequiring mechanical ventilation resulting in more incidences of ventilator associated pneumonia(VAP). Despite vast research on COVID 19 complications, very few studies have looked at the riskfactors of VAP in this population. The purpose of this study is to bridge this gap by identifying clinicaland laboratory predictors of VAP in critically ill COVID-19 patients.

Methods: Shahid Beheshti Hospital, Kashan was the site of a retrospective analysis of 235 COVID 19ICU patients requiring mechanical ventilation. Therapeutic interventions were assessed and clinicalsymptoms, laboratory markers were assessed.

Results: Fever and chills were also found to be associated with nearly a threefold increase in risk (p <0.05) as was abnormal heart rate, which increased the risk fourfold (p < 0.001), and WBC and ESRsignificantly correlated with VAP occurrence. In addition, patients not treated with tocilizumab had asixfold increase in risk of VAP (p < 0.001). Early identification and targeted interventions to mitigatethe risk of VAP in COVID-19 patients being mechanically ventilated is a focus of this study.

Conclusion: Results indicate immunomodulatory therapy may provide a protective role, andunderscore the importance of strict infection control. Future research should model causal mechanismsand develop best treatment strategies to reduce the incidence of VAP.