感染与入住重症监护室 (ICU) 的COVID-19患者的死亡率增加无关
James Ainsworth1, Peter Sewell1, Sabine Eggert1
1Ed Major Intensive Care Unit, Morriston Hospital, Swansea, UK.
Critical care research and practice
|September 18, 2023
概括
近一半的COVID-19重症监护室 (ICU) 患者患有二次真菌感染,主要是Candida物种. 诸如更长的ICU停留和类固醇使用等因素增加了风险,但真菌感染没有影响死亡率.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 菌类学 菌类学是指菌类学.
背景情况:
- 真菌感染对重症患者,特别是重症监护室 (ICU) 患者构成重大风险.
- 在ICU中的COVID-19患者被认为具有特别高的风险发展二次真菌感染,增加发病率和死亡率.
研究的目的:
- 确定COVID-19入住ICU的患者中二次真菌感染的发生率.
- 在这个患者群体中识别与真菌感染相关的风险因素.
- 为了比较COVID-19患者与没有真菌感染之间的死亡率.
主要方法:
- 在英国威尔士的第三级ICU中进行了一项回顾性观察研究.
- 分析了2020年3月至2021年5月期间入院的174名COVID-19患者的数据.
- 审查了患者的临床笔记和微生物学结果.
主要成果:
- 47%的COVID-19患者 (81/174) 患有真菌感染,主要是Candida物种 (93%).
- 加长ICU停留时间,住院时间,皮质类固醇治疗时间和机械通风时间显著与真菌感染有关.
- 在患有和没有真菌感染的患者中,死亡率相似 (51%对52%),在Kaplan-Meier分析中,真菌感染显示出生存益处 (p < 0.001).
结论:
- 二次性真菌感染在COVID-19的ICU患者中很常见.
- 长时间的机械通风,使用皮质类固醇和长时间住院/ICU是真菌感染的重要风险因素.
- 在这个队列中,真菌感染与死亡率的增加无关.
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