PNEUMONIA E VENTILAÇÃO MECÂNICA NA COVID-19: REVISÃO

Abstract

The COVID-19 pandemic caused a significant global transformation. In light of this scenario, various studies have been conducted to understand the biology of the virus, its symptoms, prevention, and treatment of the disease. In severe cases, mechanical ventilation is crucial for survival, but paradoxically, it may increase the risk of ventilator-associated pneumonia (VAP). Given the growing interest in identifying clinical approaches related to secondary symptoms of the disease, this study aimed to conduct a systematic review on the occurrence of VAP in patients infected with SARS-CoV-2. The databases SCIELO, PUBMED, UpToDate, and ScienceDirect were systematically searched up to early 2023 to identify relevant articles. The central inquiry of this study focused on analyzing works that address VAP in COVID-19 patients, including the identification of the main causative agents. A total of 44 publications were retrieved, and after applying selection criteria and excluding review articles, 23 studies were included. The meta-analysis revealed that the most prevalent bacteria in cases of VAP were: P. aeruginosa (23.83% ± 0.12), Klebsiella sp. (21.78% ± 0.10), and S. aureus (22.03% ± 0.11), while the fungi identified were: Aspergillus fumigatus (10.60% ± 0.07) and Candida spp. (24% ± 0.19). Based on our systematic review of the literature, there is evidence that the main pathogens causing VAP during the COVID-19 pandemic are opportunistic, taking advantage of the cellular changes induced by SARS-CoV-2 infection and the resulting immune fragility to acquire pathogenicity.