https://doi.org/10.4081/monaldi.2022.2436

Factors predicting mortality among patients with COVID-19 associated hospital acquired pneumonia: insights from a tertiary care center

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Vol. 93 No. 4 (2023)
Submitted: September 23, 2022
Accepted: November 18, 2022
Published: December 14, 2022
Hospital acquired pneumonia, nosocomial infection, COVID-19, pulmonary aspergillosis
Abstract Views: 2214
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Authors

Nabila Kanwal
Department of Medicine, Aga Khan University, Karachi, Pakistan.
Humza Thobani
Aga Khan University, Karachi, Pakistan.
Ainan Arshad
ainan_arshad@hotmail.com
https://orcid.org/0000-0002-9013-3899
Department of Medicine, Aga Khan University, Karachi, Pakistan.
Priya Ashok Kumar
Aga Khan University, Karachi, Pakistan.
Fatima Amjad
https://orcid.org/0000-0002-2007-2592
Aga Khan University, Pakistan.
Safia Awan
Department of Medicine, Aga Khan University, Karachi, Pakistan.
Muhammad Irfan
https://orcid.org/0000-0002-5796-2548
Department of Medicine, Section of Pulmonology and Critical Care, Aga Khan University, Karachi, Pakistan.

Hospital acquired pneumonia (HAP) is a severe and dangerous complication in patients admitted with COVID-19, causing significant morbidity and mortality globally. However, the early detection and subsequent management of high-risk cases may prevent disease progression and improve clinical outcomes. This study was undertaken in order to identify predictors of mortality in COVID-19 associated HAP. A retrospective study was performed on all patients who were admitted to a tertiary care center with COVID-19 associated HAP from July 2020 till November 2020. Data was collected on relevant demographic, clinical and laboratory parameters to determine their association with in-hospital mortality; 1574 files were reviewed, out of which 162 were included in the final study. The mean age of subjects was 59.4±13.8 and a majority were male (78.4%). There were 71 (48.3%) mortalities in the study sample. Klebsiella pneumoniae (31.5%) and Pseudomonas aeruginosa (30.2%) were the most common organisms overall. Clinically significant growth of Aspergillus sp. was observed in 41 (29.0%) of patients. On univariate analysis, several factors were found to be associated with mortality, including male gender (p=0.04), D-dimers >1.3 mg/L (p<0.001), ferritin >1000 µg/mL (p<0.001), LDH >500I.U/mL (p<0.001) and procalcitonin >2.0 µg/mL (p<0.001). On multivariate analysis, ferritin >1000ng/mL, initial site of care in Special Care Units or Intensive Care Units, developing respiratory failure and developing acute kidney injury were factors independently associated with mortality in our patient sample. These results indicate that serum ferritin levels may be a potentially useful biomarker in the management of COVID-19 associated HAP.

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How to Cite

Kanwal, Nabila, Humza Thobani, Ainan Arshad, Priya Ashok Kumar, Fatima Amjad, Safia Awan, and Muhammad Irfan. 2022. “Factors Predicting Mortality Among Patients With COVID-19 Associated Hospital Acquired Pneumonia: Insights from a Tertiary Care Center”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2022.2436.
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