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  1. Article ; Online: Secondary pneumonias in critically ill patients with COVID-19: risk factors and outcomes.

    Povoa, Pedro / Martin-Loeches, Ignacio / Nseir, Saad

    Current opinion in critical care

    2021  Volume 27, Issue 5, Page(s) 468–473

    Abstract: ... of secondary pneumonias in COVID-19 patients, its incidence, risk factors and impact outcomes.: Recent ... According to the current evidence, COVID-19 patients are at an increased risk of secondary pneumonias ... findings: Early studies reported low incidence of hospital-acquired infections in COVID-19 patients. More ...

    Abstract Purpose of review: The aim of this review is to provide an overview of the current evidence of secondary pneumonias in COVID-19 patients, its incidence, risk factors and impact outcomes.
    Recent findings: Early studies reported low incidence of hospital-acquired infections in COVID-19 patients. More recent large studies clearly showed that the incidence of secondary pneumonias was markedly high in patients under mechanical ventilation. Duration of mechanical ventilation, acute respiratory distress syndrome, prone position and male sex were identified as risk factors. The adjunctive therapy with steroids and immunomodulators were associated with a higher risk of pneumonia and invasive pulmonary Aspergillosis. Although secondary pneumonias seemed to be associated with poor outcomes, namely mortality, in comparison with influenza, no difference was found in heterogeneity of outcomes. Immunosuppressive therapy has been studied in several observational and randomized trials with conflicting results and the true impact on superinfections, namely secondary pneumonias, has not been properly assessed.
    Summary: According to the current evidence, COVID-19 patients are at an increased risk of secondary pneumonias. The impact of immunosuppressive therapies on superinfections is yet to be determined. Further studies are needed to assess the true risk of secondary infections associated with immunosuppressive therapies and to identify preventive strategies.
    MeSH term(s) COVID-19 ; Critical Illness ; Humans ; Male ; Pneumonia/epidemiology ; Pneumonia/etiology ; Respiration, Artificial/adverse effects ; Risk Factors ; SARS-CoV-2
    Language English
    Publishing date 2021-07-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000860
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4999: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Secondary infections in critically ill patients with COVID-19: A retrospective single-center study.

    Haque, Obaid I / Shameem, Mohammad / Hashim, Wamin

    Lung India : official organ of Indian Chest Society

    2023  Volume 40, Issue 3, Page(s) 210–214

    Abstract: ... in critically ill patients with COVID-19.: Methods: All adult COVID-19 patients admitted ... Conclusion: The incidence of secondary bacterial infections was high in critically ill patients with COVID ... the incidence, associated risk factors, outcomes, and pathogens associated with secondary bacterial infections ...

    Abstract Background: Patients infected with COVID-19 admitted to the intensive care unit (ICU) may have a higher incidence of developing secondary infections. These infections can further deteriorate the hospital course and increase mortality. Therefore, the objectives of this study were to investigate the incidence, associated risk factors, outcomes, and pathogens associated with secondary bacterial infections in critically ill patients with COVID-19.
    Methods: All adult COVID-19 patients admitted to the intensive care unit requiring mechanical ventilation from October 1, 2020 until December 31, 2021 were screened for inclusion in the study. A total of 86 patients were screened and 65 who met the inclusion criteria were prospectively entered into a customized electronic database. The database was then retrospectively analyzed to investigate secondary bacterial infections.
    Results: Of the 65 patients included, 41.54% acquired at least one of the studied secondary bacterial infections during the course of their ICU stay. The most common secondary infection (59.26%) seen was hospital-acquired pneumonia followed by acquired bacteremia of unknown origin (25.92%) and catheter-related sepsis (14.81%). Diabetes mellitus (P = <.001), cumulative dose of corticosteroids (P = 0.001), were associated with an increased risk of secondary bacterial infection. The most commonly isolated pathogen in patients with secondary pneumonia was Acinetobacter baumannii. Staphylococcus aureus was the most common organism associated with a bloodstream infection and catheter-related sepsis.
    Conclusion: The incidence of secondary bacterial infections was high in critically ill patients with COVID-19 and was associated with a longer duration of admission to the hospital and ICU and a higher mortality. Diabetes mellitus and cumulative dose of corticosteroids were associated with significantly increased risk of secondary bacterial infection.
    Language English
    Publishing date 2023-04-26
    Publishing country India
    Document type Journal Article
    ZDB-ID 2410801-7
    ISSN 0974-598X ; 0970-2113
    ISSN (online) 0974-598X
    ISSN 0970-2113
    DOI 10.4103/lungindia.lungindia_293_22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: State-of-the-art review of secondary pulmonary infections in patients with COVID-19 pneumonia.

    Chong, Woon H / Saha, Biplab K / Ananthakrishnan Ramani / Chopra, Amit

    Infection

    2021  Volume 49, Issue 4, Page(s) 591–605

    Abstract: ... the incidence, risk factors, and outcomes of secondary pulmonary infections in hospitalized COVID-19 patients. ... predominantly seen in critically ill hospitalized COVID-19 patients. The most common bacterial microorganisms ... COVID-19 patients. Understanding the incidence of secondary pulmonary infections and the associated ...

    Abstract Background: The incidence of secondary pulmonary infections is not well described in hospitalized COVID-19 patients. Understanding the incidence of secondary pulmonary infections and the associated bacterial and fungal microorganisms identified can improve patient outcomes.
    Objective: This narrative review aims to determine the incidence of secondary bacterial and fungal pulmonary infections in hospitalized COVID-19 patients, and describe the bacterial and fungal microorganisms identified.
    Method: We perform a literature search and select articles with confirmed diagnoses of secondary bacterial and fungal pulmonary infections that occur 48 h after admission, using respiratory tract cultures in hospitalized adult COVID-19 patients. We exclude articles involving co-infections defined as infections diagnosed at the time of admission by non-SARS-CoV-2 viruses, bacteria, and fungal microorganisms.
    Results: The incidence of secondary pulmonary infections is low at 16% (4.8-42.8%) for bacterial infections and lower for fungal infections at 6.3% (0.9-33.3%) in hospitalized COVID-19 patients. Secondary pulmonary infections are predominantly seen in critically ill hospitalized COVID-19 patients. The most common bacterial microorganisms identified in the respiratory tract cultures are Pseudomonas aeruginosa, Klebsiella species, Staphylococcus aureus, Escherichia coli, and Stenotrophomonas maltophilia. Aspergillus fumigatus is the most common microorganism identified to cause secondary fungal pulmonary infections. Other rare opportunistic infection reported such as PJP is mostly confined to small case series and case reports. The overall time to diagnose secondary bacterial and fungal pulmonary infections is 10 days (2-21 days) from initial hospitalization and 9 days (4-18 days) after ICU admission. The use of antibiotics is high at 60-100% involving the studies included in our review.
    Conclusion: The widespread use of empirical antibiotics during the current pandemic may contribute to the development of multidrug-resistant microorganisms, and antimicrobial stewardship programs are required for minimizing and de-escalating antibiotics. Due to the variation in definition across most studies, a large, well-designed study is required to determine the incidence, risk factors, and outcomes of secondary pulmonary infections in hospitalized COVID-19 patients.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship ; COVID-19/complications ; COVID-19/epidemiology ; Coinfection/diagnosis ; Coinfection/drug therapy ; Coinfection/epidemiology ; Coinfection/microbiology ; Drug Resistance, Multiple ; Humans ; Incidence ; Lung Diseases, Fungal/epidemiology ; Lung Diseases, Fungal/etiology ; Lung Diseases, Fungal/microbiology ; Pneumonia, Bacterial/epidemiology ; Pneumonia, Bacterial/etiology ; Pneumonia, Bacterial/microbiology ; SARS-CoV-2 ; Time Factors
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-03-11
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 185104-4
    ISSN 1439-0973 ; 0300-8126 ; 0173-2129
    ISSN (online) 1439-0973
    ISSN 0300-8126 ; 0173-2129
    DOI 10.1007/s15010-021-01602-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 881: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 528: Show issues

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  4. Article ; Online: Hepatobiliary long-term consequences of COVID-19: dramatically increased rate of secondary sclerosing cholangitis in critically ill COVID-19 patients.

    Leonhardt, Silke / Jürgensen, Christian / Frohme, Josephine / Grajecki, Donata / Adler, Andreas / Sigal, Michael / Leonhardt, Julia / Voll, Julian M / Kruse, Jan Matthias / Körner, Roland / Eckardt, Kai-Uwe / Janssen, Hans-Joachim / Gebhardt, Volker / Schmittner, Marc D / Frey, Christian / Müller-Ide, Hendrik / Bauer, Michael / Thibeault, Charlotte / Kurth, Florian /
    Sander, Leif Erik / Müller, Tobias / Tacke, Frank

    Hepatology international

    2023  Volume 17, Issue 6, Page(s) 1610–1625

    Abstract: ... of secondary sclerosing cholangitis in critically ill COVID-19 patients (SSC-CIP) were signs of systemic ... invasively ventilated COVID-19 patients developed this complication. Risk factors preceding the development ... proportion of critically ill patients. SSC-CIP most likely develops due to severe tissue hypoxia and ...

    Abstract Background: Increasing evidence suggests that secondary sclerosing cholangitis (SSC), which can lead to cirrhosis or liver failure, may be a hepatobiliary long-term complication of COVID-19. The aim of this study was to estimate the frequency and outcome of this COVID-19 sequela and to identify possible risk factors.
    Methods: This observational study, conducted at University Hospital Charité Berlin and Unfallkrankenhaus Berlin, Germany, involved hospitalized patients with COVID-19 pneumonia, including 1082 ventilated COVID-19 patients. We compared COVID-19 patients who developed SSC with a COVID-19 control group by univariate and multivariate analyses.
    Results: SSC occurrence after COVID-19 was observed exclusively in critically ill patients with invasive ventilation, albeit with extreme clustering among them. One in every 43 invasively ventilated COVID-19 patients developed this complication. Risk factors preceding the development of secondary sclerosing cholangitis in critically ill COVID-19 patients (SSC-CIP) were signs of systemic reduced blood oxygen supply (e.g., low PaO
    Conclusions: COVID-19 causes SSC-CIP in a substantial proportion of critically ill patients. SSC-CIP most likely develops due to severe tissue hypoxia and fibrinogen-associated circulatory disturbances. A significant increase of patients with SSC-CIP is to be expected in the post-COVID era.
    MeSH term(s) Humans ; Cholangitis, Sclerosing/complications ; Cholangitis, Sclerosing/therapy ; Critical Illness ; COVID-19/complications ; Liver Cirrhosis/complications ; Fibrinogen
    Chemical Substances Fibrinogen (9001-32-5)
    Language English
    Publishing date 2023-04-29
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 2270316-0
    ISSN 1936-0541 ; 1936-0533
    ISSN (online) 1936-0541
    ISSN 1936-0533
    DOI 10.1007/s12072-023-10521-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Secondary sclerosing cholangitis after COVID-19 pneumonia: a report of two cases and review of the literature.

    Bauer, Ulrike / Pavlova, Desislava / Abbassi, Rami / Lahmer, Tobias / Geisler, Fabian / Schmid, Roland M / Ehmer, Ursula

    Clinical journal of gastroenterology

    2022  Volume 15, Issue 6, Page(s) 1124–1129

    Abstract: ... to severe COVID-19 pneumonia. Both patients required invasive ventilation for 31 and 141 days, respectively ... COVID-19 infection. The vast majority of the patients described in these reports were male and had ... Secondary sclerosing cholangitis in critically ill patients (SC-CIP) is a rare disease ...

    Abstract Secondary sclerosing cholangitis in critically ill patients (SC-CIP) is a rare disease characterized by chronic cholestasis. The underlying pathophysiology of SC-CIP is not fully understood, and prognosis in severe cases remains poor with liver transplantation remaining the only curative treatment option. There is a growing amount of literature describing patients with chronic cholangiopathy after COVID-19 infection. The vast majority of the patients described in these reports were male and had a poor outcome. While the exact percentage of patients with COVID-19-related SC-CIP cannot be estimated accurately due to a lack of larger studies, an increase in patients with long-term complications of chronic cholestatic liver disease after severe COVID19-pneumonia can be expected in the upcoming years. Treatment options remain limited and further research is needed to improve the dismal prognosis of SC-CIP. Here, we present the cases of two patients who developed SC-CIP after prolonged intensive care unit stay due to severe COVID-19 pneumonia. Both patients required invasive ventilation for 31 and 141 days, respectively, as well as extra-corporal membrane oxygenation for 23 and 87 days. The patients suffered from jaundice and severe pruritus, and typical features of SC-CIP were present by MRCP and ERC. Repeated removal of biliary casts resulted in some alleviation of their clinical symptoms, but cholestasis parameters remain elevated. Furthermore, an increased liver stiffness was indicative of advanced fibrosis in both patients. In addition to these two case reports, we provide a concise review of the literature of SC-CIP after COVID-19 infection and discuss risk factors, treatment options and prognosis.
    MeSH term(s) Humans ; Male ; Female ; Cholangitis, Sclerosing/complications ; Cholangitis, Sclerosing/diagnosis ; COVID-19/complications ; Critical Illness/therapy ; Liver Transplantation/adverse effects ; Cholestasis
    Language English
    Publishing date 2022-08-11
    Publishing country Japan
    Document type Review ; Case Reports ; Journal Article
    ZDB-ID 2429411-1
    ISSN 1865-7265 ; 1865-7257
    ISSN (online) 1865-7265
    ISSN 1865-7257
    DOI 10.1007/s12328-022-01687-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Clinical and etiological analysis of co-infections and secondary infections in COVID-19 patients: An observational study.

    Chen, Shuyan / Zhu, Qing / Xiao, Yanyu / Wu, Chi / Jiang, Zhaofang / Liu, Lei / Qu, Jiuxin

    The clinical respiratory journal

    2021  Volume 15, Issue 7, Page(s) 815–825

    Abstract: ... COVID-19 patients. Hospital-acquired infection pathogens were more common in critically ill patients ... secondary infections existed in hospitalized COVID-19 patients and were relevant to the disease severity. Screening ... for poor outcomes in viral infections. The prevalence of co-infection and secondary infection in patients ...

    Abstract Background: Co-infections, secondary bacterial or fungal infections, are important risk factors for poor outcomes in viral infections. The prevalence of co-infection and secondary infection in patients infected with SARS-CoV-2 is not well understood.
    Aims: To investigate the role of co-infections and secondary infections in disease severity of hospitalized individuals with COVID-19.
    Materials and methods: A retrospective study was carried out between 11 January 2020 and 1 March 2020 among 408 laboratory confirmed COVID-19 patients in China. These patients were divided into three groups based on disease severity: mild or moderate, severe, or critically ill. Microbiological pathogens in blood, urine, and respiratory tract specimens were detected by the combination of culture, serology, polymerase chain reaction, and metagenomic next-generation sequencing (mNGS).
    Results: The median age of participants was 48 years (IQR 34-60 years). Fifty-two patients (12.7%) had at least one additional pathogen, 8.1% were co-infected, and 5.1% had a secondary infection. There were 13 Mycoplasma pneumoniae cases, 8 Haemophilus influenzae cases, 8 respiratory viruses, and 3 Streptococcus pneumoniae cases, primarily detected in mild and moderate COVID-19 patients. Hospital-acquired infection pathogens were more common in critically ill patients. Compared to those without additional pathogens, patients with co-infections and/or secondary infections were more likely to receive antibiotics (p < 0.001) and have elevated levels of d-dimer (p = 0.0012), interleukin-6 (p = 0.0027), and procalcitonin (p = 0.0002). The performance of conventional culture was comparable with that of mNGS in diagnosis of secondary infections.
    Conclusion: Co-infections and secondary infections existed in hospitalized COVID-19 patients and were relevant to the disease severity. Screening of common respiratory pathogens and hospital infection control should be strengthened.
    MeSH term(s) Adult ; COVID-19 ; Coinfection/epidemiology ; Humans ; Middle Aged ; Retrospective Studies ; SARS-CoV-2 ; Virus Diseases
    Language English
    Publishing date 2021-04-19
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2442214-9
    ISSN 1752-699X ; 1752-6981
    ISSN (online) 1752-699X
    ISSN 1752-6981
    DOI 10.1111/crj.13369
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