Ventilator-Associated Pneumonia and COVID-19
In the study, investigators found that nearly half of patients with COVID-19 developed a secondary ventilator-associated bacterial pneumonia, which they referred to as “ventilator-associated pneumonia,” or VAP.
“Recent data suggest that secondary pneumonia is present in up to 40% and pneumonia or diffuse alveolar damage is present in over 90% of autopsy specimens obtained from patients with acute SARS-CoV-2 infection,” the authors of the study wrote, referring to the scientific name for the virus that causes COVID-19.
“Consistent with these observations, we and others found high rates of ventilator-associated pneumonia (VAP) in patients with SARS-CoV-2 pneumonia requiring mechanical ventilation, suggesting that bacterial superinfections such as VAP may contribute to mortality in patients with COVID-19,” they continued.
“These findings prompt an alternative hypothesis that a relatively low mortality rate directly attributable to primary SARS-CoV-2 infection is offset by a greater risk of death attributable to unresolving VAP,” they continued.
Out of 601 mechanically ventilated patients enrolled in the study, 585 had some form of severe pneumonia and respiratory failure. Of the ones with severe pneumonia and respiratory failure, 190 had COVID-19, 50 had pneumonia related to other viruses, 252 had bacterial pneumonia, and 93 had respiratory failure unrelated to pneumonia.
The numbers indicate that perhaps 59 percent of the cases were respiratory issues other than COVID-19 or other viruses (43 percent bacterial pneumonia, 16 percent respiratory failure unrelated to pneumonia).
The senior author of the study, Dr. Benjamin Singer, a pulmonary and critical care physician, told the Northwestern Medicine Feinberg School of Medicine news center that “our data suggested that the mortality related to the [COVID-19] virus itself is relatively low, but other things that happen during the ICU stay, like secondary bacterial pneumonia, offset that.”
[ . . . ] here is the causal chain,” Dr. Stupak said of the claim that around 80 percent of ventilated COVID-19 patients died.
He explained that it’s not the ventilators themselves that killed the patients but “the application of sedation for intubation,” which he said reduces the excursion of the chest wall muscles and causes parts of the lung to fill with fluid “appearing to be pneumonia itself.”
Dr. Stupak said that there was a push to sedate and intubate COVID-19 patients due to a “panic” among hospital staff that feared COVID-19 contagion and so rushed to put patients on ventilators to protect themselves from infection.
“Mass sedation of the elderly was the primary weapon, ventilator and ICU mismanagement only a secondary factor that is a result of the first,” Dr. Stupak said in a follow-up post.
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