Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/144835 |
Resumo: | Funding This study was supported in part by a grant from the French government through the « Programme Investissement d’Avenir» (I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). Prof. Ignacio Martin-Loeches has been supported by SFI (Science Foundation Ireland), Grant number 20/COV/0038. The funders of the study had no role in the study design, data collection, analysis or interpretation, writing of the report or deci sion to submit for publication. |
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Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patientsa retrospective multicenter studyCorticosteroidsCOVID-19SARS-CoV-2Ventilator-associated lower respiratory tract infectionsCritical Care and Intensive Care MedicineFunding This study was supported in part by a grant from the French government through the « Programme Investissement d’Avenir» (I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). Prof. Ignacio Martin-Loeches has been supported by SFI (Science Foundation Ireland), Grant number 20/COV/0038. The funders of the study had no role in the study design, data collection, analysis or interpretation, writing of the report or deci sion to submit for publication.BACKGROUND: Ventilator-associated pneumonia (VAP) is common in patients with severe SARS-CoV-2 pneumonia. The aim of this ancillary analysis of the coVAPid multicenter observational retrospective study is to assess the relationship between adjuvant corticosteroid use and the incidence of VAP. METHODS: Planned ancillary analysis of a multicenter retrospective European cohort in 36 ICUs. Adult patients receiving invasive mechanical ventilation for more than 48 h for SARS-CoV-2 pneumonia were consecutively included between February and May 2020. VAP diagnosis required strict definition with clinical, radiological and quantitative microbiological confirmation. We assessed the association of VAP with corticosteroid treatment using univariate and multivariate cause-specific Cox's proportional hazard models with adjustment on pre-specified confounders. RESULTS: Among the 545 included patients, 191 (35%) received corticosteroids. The proportional hazard assumption for the effect of corticosteroids on the incidence of VAP could not be accepted, indicating that this effect varied during ICU stay. We found a non-significant lower risk of VAP for corticosteroid-treated patients during the first days in the ICU and an increased risk for longer ICU stay. By modeling the effect of corticosteroids with time-dependent coefficients, the association between corticosteroids and the incidence of VAP was not significant (overall effect p = 0.082), with time-dependent hazard ratios (95% confidence interval) of 0.47 (0.17-1.31) at day 2, 0.95 (0.63-1.42) at day 7, 1.48 (1.01-2.16) at day 14 and 1.94 (1.09-3.46) at day 21. CONCLUSIONS: No significant association was found between adjuvant corticosteroid treatment and the incidence of VAP, although a time-varying effect of corticosteroids was identified along the 28-day follow-up.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNSaura, OurielRouzé, AnahitaMartin-Loeches, IgnacioPovoa, PedroKreitmann, LouisTorres, AntoniMetzelard, MatthieuDu Cheyron, DamienLambiotte, FabienTamion, FabienneLabruyere, MarieBoulle Geronimi, ClaireLuyt, Charles EdouardNyunga, MartinePouly, OlivierThille, Arnaud W.Megarbane, BrunoSaade, AnastasiaMagira, EleniLlitjos, Jean FrançoisIoannidou, IlianaPierre, AlexandreReignier, JeanGarot, DenisBaudel, Jean LucVoiriot, GuillaumePlantefeve, GaëtanMorawiec, EliseAsfar, PierreBoyer, AlexandreMekontso-Dessap, ArmandBardaka, FotiniDiaz, EmiliVinsonneau, ChristopheFloch, Pierre EdouardWeiss, NicolasCeccato, AdrianArtigas, AntonioNora, DavidDuhamel, AlainLabreuche, JulienNseir, Saad2022-10-18T22:12:45Z2022-09-272022-09-27T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1application/pdfhttp://hdl.handle.net/10362/144835eng1364-8535PURE: 47065129https://doi.org/10.1186/s13054-022-04170-2info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:24:47Zoai:run.unl.pt:10362/144835Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:51:46.565118Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients a retrospective multicenter study |
title |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients |
spellingShingle |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients Saura, Ouriel Corticosteroids COVID-19 SARS-CoV-2 Ventilator-associated lower respiratory tract infections Critical Care and Intensive Care Medicine |
title_short |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients |
title_full |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients |
title_fullStr |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients |
title_full_unstemmed |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients |
title_sort |
Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients |
author |
Saura, Ouriel |
author_facet |
Saura, Ouriel Rouzé, Anahita Martin-Loeches, Ignacio Povoa, Pedro Kreitmann, Louis Torres, Antoni Metzelard, Matthieu Du Cheyron, Damien Lambiotte, Fabien Tamion, Fabienne Labruyere, Marie Boulle Geronimi, Claire Luyt, Charles Edouard Nyunga, Martine Pouly, Olivier Thille, Arnaud W. Megarbane, Bruno Saade, Anastasia Magira, Eleni Llitjos, Jean François Ioannidou, Iliana Pierre, Alexandre Reignier, Jean Garot, Denis Baudel, Jean Luc Voiriot, Guillaume Plantefeve, Gaëtan Morawiec, Elise Asfar, Pierre Boyer, Alexandre Mekontso-Dessap, Armand Bardaka, Fotini Diaz, Emili Vinsonneau, Christophe Floch, Pierre Edouard Weiss, Nicolas Ceccato, Adrian Artigas, Antonio Nora, David Duhamel, Alain Labreuche, Julien Nseir, Saad |
author_role |
author |
author2 |
Rouzé, Anahita Martin-Loeches, Ignacio Povoa, Pedro Kreitmann, Louis Torres, Antoni Metzelard, Matthieu Du Cheyron, Damien Lambiotte, Fabien Tamion, Fabienne Labruyere, Marie Boulle Geronimi, Claire Luyt, Charles Edouard Nyunga, Martine Pouly, Olivier Thille, Arnaud W. Megarbane, Bruno Saade, Anastasia Magira, Eleni Llitjos, Jean François Ioannidou, Iliana Pierre, Alexandre Reignier, Jean Garot, Denis Baudel, Jean Luc Voiriot, Guillaume Plantefeve, Gaëtan Morawiec, Elise Asfar, Pierre Boyer, Alexandre Mekontso-Dessap, Armand Bardaka, Fotini Diaz, Emili Vinsonneau, Christophe Floch, Pierre Edouard Weiss, Nicolas Ceccato, Adrian Artigas, Antonio Nora, David Duhamel, Alain Labreuche, Julien Nseir, Saad |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
dc.contributor.author.fl_str_mv |
Saura, Ouriel Rouzé, Anahita Martin-Loeches, Ignacio Povoa, Pedro Kreitmann, Louis Torres, Antoni Metzelard, Matthieu Du Cheyron, Damien Lambiotte, Fabien Tamion, Fabienne Labruyere, Marie Boulle Geronimi, Claire Luyt, Charles Edouard Nyunga, Martine Pouly, Olivier Thille, Arnaud W. Megarbane, Bruno Saade, Anastasia Magira, Eleni Llitjos, Jean François Ioannidou, Iliana Pierre, Alexandre Reignier, Jean Garot, Denis Baudel, Jean Luc Voiriot, Guillaume Plantefeve, Gaëtan Morawiec, Elise Asfar, Pierre Boyer, Alexandre Mekontso-Dessap, Armand Bardaka, Fotini Diaz, Emili Vinsonneau, Christophe Floch, Pierre Edouard Weiss, Nicolas Ceccato, Adrian Artigas, Antonio Nora, David Duhamel, Alain Labreuche, Julien Nseir, Saad |
dc.subject.por.fl_str_mv |
Corticosteroids COVID-19 SARS-CoV-2 Ventilator-associated lower respiratory tract infections Critical Care and Intensive Care Medicine |
topic |
Corticosteroids COVID-19 SARS-CoV-2 Ventilator-associated lower respiratory tract infections Critical Care and Intensive Care Medicine |
description |
Funding This study was supported in part by a grant from the French government through the « Programme Investissement d’Avenir» (I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). Prof. Ignacio Martin-Loeches has been supported by SFI (Science Foundation Ireland), Grant number 20/COV/0038. The funders of the study had no role in the study design, data collection, analysis or interpretation, writing of the report or deci sion to submit for publication. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-10-18T22:12:45Z 2022-09-27 2022-09-27T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/144835 |
url |
http://hdl.handle.net/10362/144835 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1364-8535 PURE: 47065129 https://doi.org/10.1186/s13054-022-04170-2 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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1 application/pdf |
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