Ventilator-Associated Pneumonia in Patients with COVID-19: A Systematic Review and Meta-Analysis

• Main Authors: Mariachiara Ippolito, Giovanni Misseri, Giulia Catalisano, Claudia Marino, Giulia Ingoglia, Marta Alessi, Elisa Consiglio, Cesare Gregoretti, Antonino Giarratano, Andrea Cortegiani
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Antibiotics
• Subjects: COVID-19; ventilator-associated pneumonia; meta-analysis; invasive mechanical ventilation
• Online Access: https://www.mdpi.com/2079-6382/10/5/545

The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of ventilator-associated pneumonia (VAP) among patients admitted to an intensive care unit with COVID-19 and mortality of those who developed VAP. We performed a systematic search on PubMed, EMBASE and Web of Science from inception to 2^nd March 2021 for nonrandomized studies specifically addressing VAP in adult patients with COVID-19 and reporting data on at least one primary outcome of interest. Random effect single-arm meta-analysis was performed for the occurrence of VAP and mortality (at the longest follow up) and ICU length of stay. Twenty studies were included in the systematic review and meta-analysis, for a total of 2611 patients with at least one episode of VAP. The pooled estimated occurrence of VAP was of 45.4% (95% C.I. 37.8–53.2%; 2611/5593 patients; I² = 96%). The pooled estimated occurrence of mortality was 42.7% (95% C.I. 34–51.7%; 371/946 patients; I² = 82%). The estimated summary estimated metric mean ICU LOS was 28.58 days (95% C.I. 21.4–35.8; I² = 98%). Sensitivity analysis showed that patients with COVID-19 may have a higher risk of developing VAP than patients without COVID-19 (OR 3.24; 95% C.I. 2.2–4.7; P = 0.015; I² = 67.7%; five studies with a comparison group).