%0 Journal Article
%A Reyes, Luis Felipe
%A Rodriguez, Alejandro
%A Bastidas, Alirio
%A Parra-Tanoux, Daniela
%A Fuentes, Yuli V
%A García-Gallo, Esteban
%A Moreno, Gerard
%A Ospina-Tascon, Gustavo
%A Hernandez, Glenn
%A Silva, Edwin
%A Díaz, Ana Maria
%A Jibaja, Manuel
%A Vera, Magdalena
%A Díaz, Emilio
%A Bodí, María
%A Solé-Violán, Jordi
%A Ferrer, Ricard
%A Albaya-Moreno, Antonio
%A Socias, Lorenzo
%A Estella, Ángel
%A Loza-Vazquez, Ana
%A Jorge-García, Ruth
%A Sancho, Isabel
%A Martin-Loeches, Ignacio
%A LIVEN-COVID-19 Investigators and COVID-19 SEMICYUC Study Group
%T Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19.
%D 2022
%U http://hdl.handle.net/10668/22297
%X Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, especially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19. This was a multicenter, prospective cohort study; conducted in ten countries in Latin America and Europe. We included patients older than 18 with confirmed SARS-CoV-2 requiring ICU admission. A multivariate logistic regression and propensity score matching (PSM) analysis was conducted to determine the relation between dexamethasone treatment and ICU-RTI. A total of 3777 patients were included. 2065 (54.7%) were treated with dexamethasone within the first 24 h of admission. After performing the PSM, patients treated with dexamethasone showed significantly higher proportions of VAP (282/1652 [17.1%] Vs. 218/1652 [13.2%], p = 0.014). Also, dexamethasone treatment was identified as an adjusted risk factor of ICU-RTI in the multivariate logistic regression model (OR 1.64; 95%CI: 1.37-1.97; p  Patients treated with dexamethasone for severe COVID-19 had a higher risk of developing ICU-acquired respiratory tract infections after adjusting for days of invasive mechanical ventilation and ICU length of stay, suggesting a cautious use of this treatment.
%K COVID-19
%K Critical care
%K Dexamethasone
%K Pneumonia
%K Severe COVID-19
%~