Secondary respiratory early and late infections in mechanically ventilated patients with COVID-19

Ceballos, María Elena; Núñez, Carolina; Uribe, Javier; Vera, María Magdalena; Castro, Ricardo; García, Patricia; Arriata, Gabriel; Gandara, Vicente; Vargas, Camila; Domínguez, Angélica; Cerón, Inés; Born, Pablo; Espíndola, Eduardo

doi:10.1186/s12879-022-07743-2

Cited by 7 publications

(8 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We first assessed the utility of bronchoscopy in the diagnosis of lower respiratory tract infections following acute COVID-19; microorganisms were diagnosed using bronchial washing and BAL, which are the most useful sampling techniques in suspected respiratory tract infections [ 21 ]. Prolonged hospitalization and immunosuppression during acute infection (i.e., corticosteroids treatment) may increase the risk of concomitant or late infections [ 22 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopy in the post-acute phase of COVID-19: an observational study

et al. 2023

View full text Add to dashboard Cite

Background Bronchoscopy is a useful technique adopted in the management of patients with COVID-19. 10–40% of COVID-19 survivors experience persistent symptoms. A comprehensive description of the utility and safety of bronchoscopy in the management of patients with COVID-19 sequelae is lacking. The aim of the study was to evaluate the role of bronchoscopy in patients with suspected post-acute sequelae of COVID-19. Methods An observational, retrospective study was carried out in Italy. Patients requiring bronchoscopy for suspected COVID-19 sequelae were enrolled. Results 45 (21, 46.7%, female) patients were recruited. Bronchoscopy was more frequently indicated for patients with a previous critical disease. The most frequent indications were tracheal complications, mostly performed in patients who were hospitalized during the acute phase than treated at home (14, 48.3% VS. 1, 6.3%; p-value: 0.007) and persistent parenchymal infiltrates, more frequent in those treated at home (9, 56.3% VS. 5, 17.2%; p-value: 0.008). 3 (6.6%) patients after the first bronchoscopy required higher oxygen flow. Four patients were diagnosed with lung cancer. Conclusion Bronchoscopy is a useful and safe technique in patients with suspected post-acute sequelae of COVID-19. The severity of acute disease plays a role in the rate and indications of bronchoscopy. Endoscopic procedures were mostly performed for tracheal complications in critical, hospitalized patients and for persistent lung parenchymal infiltrates in mild-moderate infections treated at home.

show abstract

Section: Discussionmentioning

confidence: 99%

Bronchoscopy in the post-acute phase of COVID-19: an observational study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…P. aeruginosa is a common pathogen in COVID-19 patients with secondary infections [28][29][30]. In COVID-19 patients undergoing endotracheal intubation, P. aeruginosa is the most prevalent pathogen of secondary infections [31]. Therefore, the current COVID-19 outbreak may potentially increase the risk of mixed and secondary infections, resulting in serious consequences for diabetic patients who are already struggling with P. aeruginosa infections.…”

Section: Introductionmentioning

confidence: 99%

Acarbose reduces Pseudomonas aeruginosa respiratory tract infection in type 2 diabetic mice

Liu,

Fan,

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Type 2 diabetes mellitus (T2DM) is widely prevalent worldwide, and respiratory tract infections have become the primary cause of death in T2DM patients who develop concurrent infections. Among these, Pseudomonas aeruginosa infection has been found to exhibit a high mortality rate and poor prognosis and is frequently observed in bacterial infections that are concurrent with COVID-19. Studies have suggested that acarbose can be used to treat T2DM and reduce inflammation. Our objective was to explore the effect of acarbose on P. aeruginosa respiratory tract infection in T2DM individuals and elucidate its underlying mechanism. Methods High-fat diet (HFD) induction and P. aeruginosa inhalation were used to establish a respiratory tract infection model in T2DM mice. The effect and mechanism of acarbose administered by gavage on P. aeruginosa respiratory tract infection were investigated in T2DM and nondiabetic mice using survival curves, pathological examination, and transcriptomics. Results We found that P. aeruginosa respiratory tract infection was more severe in T2DM mice than in nondiabetic individuals, which could be attributed to the activation of the NF-κB and TREM-1 signaling pathways. When acarbose alleviated P. aeruginosa respiratory tract infection in T2DM mice, both HIF-1α and NF-κB signaling pathways were inhibited. Furthermore, inhibition of the calcium ion signaling pathway and NF-κB signaling pathway contributed to the attenuation of P. aeruginosa respiratory tract infection by acarbose in nondiabetic mice. Conclusions This study confirmed the attenuating effect of acarbose on P. aeruginosa respiratory tract infections in T2DM and nondiabetic mice and investigated its mechanism, providing novel support for its clinical application in related diseases.

show abstract

“…Invasive fungal infections have increased significantly since the start of the coronavirus disease 2019 (COVID-19) pandemic [ 1 ]. Further, among critically ill COVID-19 patients, invasive fungal infections (IFIs) have emerged as the second most common secondary infection [ 2 , 3 ]. However, the reported incidence of COVID-19-associated invasive fungal infections (CAIFIs) has varied globally during different COVID-19 waves and with different cohort designs and diagnostic criteria [ 4–8 ].…”

mentioning

confidence: 99%

Incidence and Mortality of COVID-19-Associated Invasive Fungal Infections Among Critically Ill Intubated Patients: A Multicenter Retrospective Cohort Analysis

Zuniga-Moya,

Papadopoulos,

Mansoor

et al. 2024

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background An association between coronavirus disease 2019 (COVID-19)–associated invasive fungal infections (CAIFIs) and high mortality among intubated patients has been suggested in previous research. However, some of the current evidence was derived from small case series and multicenter studies conducted during different waves of the COVID-19 pandemic. We examined the incidence of CAIFIs and their associated mortality using a large, multicenter COVID-19 database built throughout the pandemic. Methods We conducted a retrospective analysis of the National COVID Cohort Collaborative (N3C) database collected from 76 medical centers in the United States between January 2020 and August 2022. Patients were 18 years or older and intubated after severe acute respiratory syndrome coronavirus 2 infection. The primary outcomes were incidence and all-cause mortality at 90 days. To assess all-cause mortality, we fitted Cox proportional hazard models after adjusting for confounders via inverse probability weighting. Results Out of the 4 916 229 patients with COVID-19 diagnosed during the study period, 68 383 (1.4%) met our cohort definition. The overall incidence of CAIFI was 2.80% (n = 1934/68 383). Aspergillus (48.2%; n = 933/1934) and Candida (41.0%; n = 793/1934) were the most common causative organisms. The incidence of CAIFIs associated with Aspergillus among patients who underwent BAL was 6.2% (n = 83/1328). Following inverse probability weighting, CAIFIs caused by Aspergillus (hazard ratio [HR], 2.0; 95% CI, 1.8–2.2) and Candida (HR, 1.7; 95% CI, 1.5–1.9) were associated with increased all-cause mortality. Systemic antifungals reduced mortality in 17% of patients with CAIFI with Aspergillus and 24% of patients with CAIFI with Candida. Conclusions The incidence of CAIFI was modest but associated with higher 90-day all-cause mortality among intubated patients. Systemic antifungals modified mortality.

show abstract

Secondary respiratory early and late infections in mechanically ventilated patients with COVID-19

Cited by 7 publications

References 34 publications

Bronchoscopy in the post-acute phase of COVID-19: an observational study

Bronchoscopy in the post-acute phase of COVID-19: an observational study

Acarbose reduces Pseudomonas aeruginosa respiratory tract infection in type 2 diabetic mice

Incidence and Mortality of COVID-19-Associated Invasive Fungal Infections Among Critically Ill Intubated Patients: A Multicenter Retrospective Cohort Analysis

Contact Info

Product

Resources

About