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10.3390/jcm11226796
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Article

Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study

by
Chuan-Yen Sun
1,
Jia-Yih Feng
1,2,
Jhong-Ru Huang
1,
Hisao-Chin Shen
1,
Yuh-Min Chen
1,2,
Wei-Chih Chen
1,2,3,† and
Kuang-Yao Yang
1,2,3,4,*,†
1
Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
2
School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
3
Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
4
Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2022, 11(22), 6796; https://doi.org/10.3390/jcm11226796
Submission received: 19 October 2022 / Revised: 13 November 2022 / Accepted: 15 November 2022 / Published: 17 November 2022
(This article belongs to the Special Issue The Challenges in Hospital Acquired Infections)
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Abstract

Objectives: This study explored the clinical outcomes and association of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in patients with severe coronavirus disease 2019 (COVID-19) infection who developed nosocomial pneumonia. Methods: This was a retrospective study conducted in a medical center in Taiwan. From May to September 2021, patients from four intensive care units were enrolled after SARS-CoV-2 was confirmed through quantitative polymerase chain reaction and all cases were compatible with the definitions of severe COVID-19 infection. Baseline characteristics, disease severity, clinical outcomes, and times of viral shedding were recorded. Results: A total of 72 patients were diagnosed as having severe COVID-19 infection and 30 developed nosocomial pneumonia, comprising hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). The patients with severe COVID-19 infection and concomitant HAP/VAP had longer intensive care unit (ICU) stays and fewer ventilator-free days at Day 28. An independent risk factor for nosocomial pneumonia was a greater SOFA score at admission. Furthermore, the patients with severe COVID-19 infection who developed HAP/VAP had a significantly longer duration of SARS-CoV-2 shedding (19.50 days vs. 15.00 days, p = 0.006). Conclusions: Patients with severe COVID-19 infection who developed nosocomial pneumonia had longer SARS-CoV-2 shedding days, more complications, and worse outcomes.
Keywords: prolonged viral shedding; coronavirus disease 2019; secondary pneumonia; severe acute respiratory syndrome coronavirus 2 prolonged viral shedding; coronavirus disease 2019; secondary pneumonia; severe acute respiratory syndrome coronavirus 2

Share and Cite

MDPI and ACS Style

Sun, C.-Y.; Feng, J.-Y.; Huang, J.-R.; Shen, H.-C.; Chen, Y.-M.; Chen, W.-C.; Yang, K.-Y. Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study. J. Clin. Med. 2022, 11, 6796. https://doi.org/10.3390/jcm11226796

AMA Style

Sun C-Y, Feng J-Y, Huang J-R, Shen H-C, Chen Y-M, Chen W-C, Yang K-Y. Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study. Journal of Clinical Medicine. 2022; 11(22):6796. https://doi.org/10.3390/jcm11226796

Chicago/Turabian Style

Sun, Chuan-Yen, Jia-Yih Feng, Jhong-Ru Huang, Hisao-Chin Shen, Yuh-Min Chen, Wei-Chih Chen, and Kuang-Yao Yang. 2022. "Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study" Journal of Clinical Medicine 11, no. 22: 6796. https://doi.org/10.3390/jcm11226796

APA Style

Sun, C.-Y., Feng, J.-Y., Huang, J.-R., Shen, H.-C., Chen, Y.-M., Chen, W.-C., & Yang, K.-Y. (2022). Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study. Journal of Clinical Medicine, 11(22), 6796. https://doi.org/10.3390/jcm11226796

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