Ventilator-Associated Pneumonia Among Patients With Covid-19: A Systematic Review

Abstract

The aim of this study is to investigate the characteristics, epidemiology, and the diagnostic criteria for VAP used most often among patients with COVID-19. PubMed, Embase, Scopus, and Google Scholar were searched between December 2019 and 1 July 2023 with the keywords ventilator-associated pneumonia, COVID-19, VAP, VAP in COVID-19, pneumonia, coronavirus, and SARS-CoV-2. Retrospective and prospective studies, case reports, and randomized controlled trial (RCT) of adults with conf i rmed cases of COVID-19 and VAP were selected for further analysis. Sixty-nine studies with 21,627 patients were included. The occurrence of VAP with COVID-19 ranged from 6%–91%; the mortality of patients with VAP with COVID-19 was 0%–100%. The dif f erence between the ranges is wide owing to dif f erences in study settings and VAP diagnostic criteria used. The bacterial strains responsible for infection were Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter species, and Staphylococcus aureus. The percentage of pneumonia associated with multidrug-resistant bacteria varied from 4% to 76%. Most studies were conducted in Europe. The diagnostic criterion used for VAP most often was that of the European Centre for Disease Prevention and Control. CTo reduce the incidence and mortality of VAP, it is crucial to create new empiric antibiotic therapy guidelines and place a focus on adopting VAP prophylaxis in the intensive care unit.