Abstract
Although few studies evaluated the incidence of hospital-acquired pneumonia (HAP)
or ventilator-associated tracheobronchitis in COVID-19 patients, several studies evaluated
the incidence of ventilator-associated pneumonia (VAP) in these patients. Based on
the results of a large multicenter European study, VAP incidence is higher in patients
with SARS-CoV-2 pneumonia (36.1%), as compared with those with influenza pneumonia
(22.2%), or no viral infection at intensive care unit (ICU) admission (16.5%). Potential
explanation for the high incidence of VAP in COVID-19 patients includes long duration
of invasive mechanical ventilation, high incidence of acute respiratory distress syndrome,
and immune-suppressive treatment. Specific risk factors for VAP, including SARS-CoV-2-related
pulmonary lesions, and bacteria–virus interaction in lung microbiota might also play
a role in VAP pathogenesis. VAP is associated with increased mortality, duration of
mechanical ventilation, and ICU length of stay in COVID-19 patients. Further studies
should focus on the incidence of HAP especially in ICU non-ventilated patients, better
determine the pathophysiology of these infections, and evaluate the accuracy of currently
available treatment guidelines in COVID-19 patients.
Keywords
ventilator-associated pneumonia - ventilator-associated tracheobronchitis - hospital-acquired
pneumonia - COVID-19 - SARS-CoV-2 - mechanical ventilation
