Ventilation Associated Pneumonia and Covid-19

Study Overview
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Brief Summary
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In December 2019, a new pandemic emerged, the COVID-19 disease caused by a SARS-Cov-2 virus. One of the most common symptoms of COVID-19 is mainly respiratory failure and patients requires assistance by mechanical ventilation. Ventilator-associated pneumonia (VAP) is a risk of this assistance. Since the beginning of the pandemic, Standard of care have evolved with new data. The prevalence of these VAPs seems significantly higher in the population of patients with ARDS COVID-19 (40-50%) and their ecology seems to have evolved over time, particularly in terms of bacterial resistance. Investigators want to describe and compare this evolution of bacterial and fungal ecology as well as identify potential risk factors that may be associated with these changes in ecology during different waves.

Official Title
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Ventilator-associated Pneumonia Ecology Comparison in a French ICU Center NIMES Between First and Second Wave of COVID-19 : a Retrospective Monocentric Descriptive Study

Conditions
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Ards, SARS-CoV2 Infection, Ventilator Associated Pneumonia, COVID-19

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 18 years Positive SARS-Cov-2 polymerase chain reaction (PCR) healthcare associated pneumonia Exclusion Criteria : Patient opposition to participate to the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patient from the first wave of COVID-19<br>57 Patients hospitalized in intensive care unit for pneumonia related to a Sars-Cov2 infection who required mechanical ventilatory support and developed microbiologically documented ventilator associated pneumonia during the 1st wave from January 24, 2020 to July 10, 2020 | |
| Patient from the Second wave of COVID-19<br>211 Patients hospitalized in intensive care unit for pneumonia related to a Sars-Cov2 infection who required mechanical ventilatory support and developed microbiologically documented ventilator associated pneumonia during the 2nd wave from July 11, 2020 to January 8, 2021 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAP ecological difference between the first and second waves of COVID | Proportion of patients admitted to critical care with documented multidrug-resistant bacteria (MDR) VAP in Covid-19 wave 1 and 2 | January 2020 to January 2021 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| proportion of fungal co-infections | Comparison of the proportion of patients with a fungal infection during the 1st and 2nd wave | January 2020 to January 2021 | 
| duration of mechanical ventilation | Number of days under mechanical ventilations | Day 28 | 
| number of days of organ failure | number of days between first organ failure and no organ failure (discharge from intensive care) | Day 28 | 
| Mortality | proportion of patients deceased at day 28 | Day 28 | 
| proportion of patients treated with corticosteroid therapy | proportion of patients treated with corticosteroid therapy | Day 28 | 
| probabilistic antibiotic therapy at admission | probabilistic antibiotic therapy prescribed at admission | Day 1 | 
| antiviral treatment | proportion of patients treated with antiviral treatment | Day 28 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intensive care Unit, multidrug resistance, COVID 19 ARDS, ventilator associated pneumonia, SARS-CoV2 Infection