COVID-19 patients face higher risks of ICU acquired infections compared to Influenza
Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 22, 2024 1 month, 2 weeks, 2 days, 17 hours, 21 minutes ago
COVID-19 News: A recent study conducted by researchers at Sahlgrenska University Hospital, Sweden, has revealed that patients with COVID-19 are more prone to intensive care unit-acquired infections (ICU-AI) than those with influenza. This
COVID-19 News report delves into the study's key findings, which highlight the significant differences in infection rates, microbial patterns, and patient outcomes between these two groups.
COVID-19 patients face higher risks of ICU acquired infections compared to Influenza
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Higher Incidence of ICU-Acquired Infections in COVID-19 Patients
The research team, comprising Dr Josefine Beck-Friis, Dr Magnus Gisslén, Dr Staffan Nilsson, Dr Anna Lindblom, Dr Jonatan Oras, and Dr Aylin Yilmaz, analyzed the medical records of 480 patients treated with invasive mechanical ventilation at Sahlgrenska University Hospital. Of these, 436 had COVID-19, while 44 had influenza. The study spanned from January 2020 to March 2022 for COVID-19 patients and from January 2015 to May 2023 for influenza patients.
The incidence rates of ICU-AI were strikingly higher among COVID-19 patients, with 31.6 infections per 1000 ICU days compared to 9.9 per 1000 ICU days for influenza patients. Ventilator-associated lower respiratory tract infections (VA-LRTIs) were the most common type of ICU-AI in both groups. The study noted that the higher incidence of ICU-AI among COVID-19 patients could be attributed to prolonged ICU stays and the increased use of invasive mechanical ventilation.
Corticosteroid Treatment and Infection Risks
Corticosteroid treatment, commonly administered to COVID-19 patients to manage inflammation, was found to be associated with an increased risk of ICU-AI. The study observed that COVID-19 patients who received corticosteroids had a higher incidence of ICU-AI and a higher 90-day mortality rate if they developed an infection. This association underscores the complexity of treating severe COVID-19 cases, where the benefits of reducing inflammation must be weighed against the risk of secondary infections.
Microbial Patterns and Outcomes
The microbial patterns of ICU-AI also differed significantly between COVID-19 and influenza patients. In the COVID-19 cohort, gram-negative bacteria were more prevalent, particularly in late-stage VA-LRTIs. In contrast, influenza patients' infections were predominantly caused by gram-positive bacteria. Notably, 18% of COVID-19 patients developed bloodstream infections (BSIs), compared to only 7% of influenza patients.
The study highlighted the longer ICU stays and increased use of broad-spectrum antibiotics among COVID-19 patients, which may contribute to the higher incidence of difficult-to-treat infections. The prolonged use of mechanical ventilation and the frequent need for corticosteroids further complicate the clinical management of these patients.
The
Impact of ICU-AI on Patient Outcomes
The study found that ICU-AI significantly affected patient outcomes, particularly among those with COVID-19. Patients with ICU-AI had a median ICU stay that was 15 days longer than those without infections. Furthermore, the presence of ICU-AI was associated with a higher 90-day mortality rate, especially among those receiving corticosteroid treatment. This finding emphasizes the need for stringent infection control measures and careful monitoring of patients receiving corticosteroids.
Addressing the Challenges in ICU Management
The increased incidence of ICU-AI among COVID-19 patients poses significant challenges for healthcare providers. The study's findings suggest that several factors, including the high demand on healthcare systems during the pandemic, alterations in immune responses caused by SARS-CoV-2, and more frequent use of prone positioning, contribute to the higher infection rates.
Moreover, the widespread use of corticosteroids, while beneficial in reducing inflammation, raises concerns about the risk of secondary bacterial and fungal infections. The study calls for further research to understand the nuances of corticosteroid use and its impact on ICU-AI across different patient populations.
Conclusion
This comprehensive study underscores the heightened risk of ICU-acquired infections among COVID-19 patients compared to those with influenza. The findings highlight the importance of balancing the benefits of corticosteroid treatment with the potential risks of secondary infections. As the medical community continues to navigate the complexities of treating severe COVID-19 cases, these insights are crucial for improving patient outcomes and enhancing infection control measures in intensive care units.
The study findings were published in the peer-reviewed journal Scientific Reports.
https://link.springer.com/article/10.1038/s41598-024-67733-z
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