Healthcare-associated Infections in Severe COVID-19 During 2020 (COVIACS)

Healthcare-associated Infections in Severe COVID-19 Patients Whit Mechanical Ventilation During 2020

In patients who develop ARDS due to SARS-CoV-2 (CARDS), a longer duration of invasive mechanical ventilation (IMV) and ICU stay has been reported compared to ARDS not associated with SARS-CoV-2. Consequently, the days of stay in ICU increase Identifying the risk factors associated with the development of this complication and developing measures aimed at its prevention could have a favorable impact on the clinical course of seriously ill patients.

Study Overview

• Status: Completed
• Conditions: COVID-19; Respiration, Artificial; Health Care Associated Infection
• Intervention / Treatment: Other: COVID-19

Detailed Description

The rate of catheter-associated bacteremia is 3.78 / 1000 days central venous catheters in polyvalent ICUs.

Some studies suggest that in the context of this pandemic, infections associated with health care have increased, although there are few data referring to Latin America.

The objective of this study is to analyze the incidence of health care associated infections in adult patients on invasive mechanical ventilation with confirmed COVID-19 diagnosis and negative COVID-19 admitted to the Intensive Care Unit of the Anchorena San Martín Clinic, San Martín, Buenos Aires.

• Study Type: Observational
• Enrollment (Actual): 252

Contacts and Locations

Study Locations

• Argentina
  • Buenos Aires
    • San Martín, Buenos Aires, Argentina, B1650CQU
      • Sanatorio Anchorena de San Martin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients admitted to ICU who required invasive mechanical ventilation during the COVID-19 pandemic from March to December 2020.

Description

Inclusion Criteria:

• All patients older than 18 years admitted to the intensive care unit of the Anchorena San Martín Clinic who required invasive mechanical ventilation for more than 24 hours in a period between March 2020 and December 2020 were included in the analysis.

Exclusion Criteria:

• All patients who presented incomplete data in the follow-up sheets were excluded.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
COVID-19 patients; Patients with invasive mechanical ventilation admitted to the Intensive Care Unit (UCI) of the Anchorena San Martín Clinic, San Martín, Buenos Aires with confirmed COVID-19 diagnosis (positive polymerase chain reaction in nasopharyngeal swab).	Other: COVID-19; Impact of covid-19 on infections associated with health care devices.
non COVID-19 patients; Patients with invasive mechanical ventilation admitted to the Intensive Care Unit (UCI) of the Anchorena San Martín Clinic, San Martín, Buenos Aires with negative COVID-19 diagnosis (positive polymerase chain reaction in nasopharyngeal swab).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Incidence of health care associated infections in each group.	March to December 2020

Secondary Outcome Measures

Outcome Measure	Time Frame
The most frequent pathogens in this population associated with Incidence of health care associated infections.	March to December 2020
Possible factors associated with Incidence of health care associated infections.	March to December 2020
mortality in UCI	March to December 2020
Days of ICU stay	March to December 2020
Days of mechanical ventilation	March to December 2020

Collaborators and Investigators

• Sponsor: Sanatorio Anchorena San Martin
• Investigators: Principal Investigator: matias accoce, SAnchorena San Martin

Publications and helpful links

General Publications

• Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A; LUNG SAFE Investigators; ESICM Trials Group. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. JAMA. 2016 Feb 23;315(8):788-800. doi: 10.1001/jama.2016.0291. Erratum In: JAMA. 2016 Jul 19;316(3):350. JAMA. 2016 Jul 19;316(3):350.
• Tufan A, Avanoglu Guler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020 Apr 21;50(SI-1):620-632. doi: 10.3906/sag-2004-168.
• Ripa M, Galli L, Poli A, Oltolini C, Spagnuolo V, Mastrangelo A, Muccini C, Monti G, De Luca G, Landoni G, Dagna L, Clementi M, Rovere Querini P, Ciceri F, Tresoldi M, Lazzarin A, Zangrillo A, Scarpellini P, Castagna A; COVID-BioB study group. Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect. 2021 Mar;27(3):451-457. doi: 10.1016/j.cmi.2020.10.021. Epub 2020 Oct 24.
• Kalanuria AA, Ziai W, Mirski M. Ventilator-associated pneumonia in the ICU. Crit Care. 2014 Mar 18;18(2):208. doi: 10.1186/cc13775. No abstract available. Erratum In: Crit Care. 2016;20:29. Zai, Wendy [corrected to Ziai, Wendy].
• Rouze A, Nseir S. Continuous control of tracheal cuff pressure for the prevention of ventilator-associated pneumonia in critically ill patients: where is the evidence? Curr Opin Crit Care. 2013 Oct;19(5):440-7. doi: 10.1097/MCC.0b013e3283636b71.
• Duszynska W, Rosenthal VD, Szczesny A, Woznica E, Ulfik K, Ostrowska E, Litwin A, Kubler A. Urinary tract infections in intensive care unit patients - a single-centre, 3-year observational study according to the INICC project. Anaesthesiol Intensive Ther. 2016;48(1):1-6. doi: 10.5603/AIT.2016.0001.
• Rosenthal VD, Dwivedy A, Calderon ME, Esen S, Hernandez HT, Abouqal R, Medeiros EA, Espinoza TA, Kanj SS, Gikas A, Barnett AG, Graves N; International Nosocomial Infection Control Consortium (INICC) Members. Time-dependent analysis of length of stay and mortality due to urinary tract infections in ten developing countries: INICC findings. J Infect. 2011 Feb;62(2):136-41. doi: 10.1016/j.jinf.2010.12.004. Epub 2010 Dec 17.
• Rouze A, Martin-Loeches I, Povoa P, Makris D, Artigas A, Bouchereau M, Lambiotte F, Metzelard M, Cuchet P, Boulle Geronimi C, Labruyere M, Tamion F, Nyunga M, Luyt CE, Labreuche J, Pouly O, Bardin J, Saade A, Asfar P, Baudel JL, Beurton A, Garot D, Ioannidou I, Kreitmann L, Llitjos JF, Magira E, Megarbane B, Meguerditchian D, Moglia E, Mekontso-Dessap A, Reignier J, Turpin M, Pierre A, Plantefeve G, Vinsonneau C, Floch PE, Weiss N, Ceccato A, Torres A, Duhamel A, Nseir S; coVAPid study Group. Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study. Intensive Care Med. 2021 Feb;47(2):188-198. doi: 10.1007/s00134-020-06323-9. Epub 2021 Jan 3. Erratum In: Intensive Care Med. 2022 Apr;48(4):514-515.

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2020
• Primary Completion (Actual): December 31, 2020
• Study Completion (Actual): January 31, 2021

Study Registration Dates

• First Submitted: March 25, 2021
• First Submitted That Met QC Criteria: March 25, 2021
• First Posted (Actual): March 26, 2021

Study Record Updates

• Last Update Posted (Actual): March 26, 2021
• Last Update Submitted That Met QC Criteria: March 25, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; Disease Attributes; Iatrogenic Disease; COVID-19; Infections; Communicable Diseases; Cross Infection
• Other Study ID Numbers: 5/2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No