ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pulmonology

Background:

• Persistent symptoms after COVID-19 are recognized in non-critically ill patients.
• Less is known about persistent COVID-19 in critically ill patients, especially those with intensive care unit-acquired pneumonia (ICUAP).
• ICUAP can prolong intensive care unit (ICU) stay and mechanical ventilation, potentially worsening post-COVID-19 outcomes.

Purpose of the Study:

• To investigate the incidence and factors associated with persistent post-COVID-19 symptoms in critically ill patients.
• To identify predictors of persistent poor health in patients discharged from the ICU after COVID-19.

Main Methods:

• Prospective, multicentre, observational study in 40 Spanish ICUs.
• Recruited consecutive COVID-19 patients requiring ICU admission.
• Evaluated patients three months after hospital discharge.

Main Results:

• Final cohort: 991 patients (78.9% follow-up).
• 315 patients (31.8%) developed ICUAP (97% ventilated).
• Independent factors for persistent poor health: female sex, longer ICU stay, ICUAP, and Acute Respiratory Distress Syndrome (ARDS).
• Patients on mechanical ventilation had more persistent symptoms.

Conclusions:

• Over two-thirds of ICU patients experienced persistent post-COVID-19 symptoms.
• Female sex, ICU stay duration, ICUAP, and ARDS are independent predictors of persistent poor health.
• Preventing ICUAP may improve long-term outcomes for post-COVID-19 patients.