Lung abscess following ventilator-associated pneumonia during COVID-19: a retrospective multicenter cohort study
Authors' conclusion
Lung abscessing pneumonia is not uncommon among COVID-19 patients developing VAP. A plurimicrobial first VAP episode and the use of hydrocortisone are independently associated with this complication.
Study context
- Population
- Patients with acute respiratory failure, confirmed SARS-CoV-2 PCR, requiring mechanical ventilation (MV) >48 h, 3 French intensive care unit (ICUs)326 with ventilator-associated pneumonia (VAP)
- Participants
- 507 patients
- Exposure
- Lung abscess vs VAP without lung abscess
- Lung abscessn = 23
- Outcome
- Incidence of lung abscess complicating VAP
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
Lung abscess among patients with VAP
Lung abscess
7%
23
Observational data: associations, not effects.
Further findings
Risk factors for lung abscess (multivariate analysis)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Plurimicrobial 1st VAP episode | 2.93 (1.16–7.51) | P = 0.02 | |
| Hydrocortisone use | 4.86 (1.95–12.1) | P = 0.001 | |
| 0.050.21520Odds ratio (log scale) |
Ventilator-free days · day 60
P < 0.001
Duration of MV
P < 0.001
ICU LOS
P < 0.001
| Outcome | Lung abscess | VAP, no lung abscess |
|---|---|---|
| ICU mortality | 52% | — not stated in the abstract |
— not stated in the abstract
Microbiology of lung abscess
- Enterobacterales
- 15/23, 65%
- Non-fermenting Gram-negative bacilli
- 10/23, 43%
- Gram-positive cocci
- 8/23, 35%
- Plurimicrobial
- 15/23, 65%
ICU mortality
- Not significantly higher than VAP without lung abscess
Original publication
Lung abscess following ventilator-associated pneumonia during COVID-19: a retrospective multicenter cohort study. Crit Care. Published 4 October 2023. doi:10.
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