Covid-19: People who used ventilator also developed secondary bacterial pneumonia

While it may no longer classify as a global health emergency by the World Health Organisation (WHO), new global studies point to other infections as causing most Covid deaths.

WHO revealed the total number of global deaths attributable to the Covid pandemic in 2020 was at least three million, representing 1.2 million more deaths than officially reported and as of 10 May 2023, there have been 765 903 278 confirmed cases of Covid including 6 927 378 deaths.

With scientists globally still at work to identify more about the virus and its impact, a new analysis suggested it was not Covid which killed most of the people who recovered from the infection after being on ventilator support.

Study

According to the analysis, compiled by a team from the Northwestern University Feinberg School of Medicine and published in a paper in the Journal of Clinical Investigation, a high percentage of people who needed help from a ventilator due to a Covid infection also developed secondary bacterial pneumonia and the pneumonia was responsible for a higher mortality rate than the Covid infection.

It was understood the researchers used machine learning, a form of artificial intelligence, to establish that secondary bacterial pneumonia, which could not be fully treated, was the sole driver of high mortality.

Northwestern University in Illinois pulmonologist Benjamin Singer said their study highlighted the importance of “preventing, looking for, and aggressively” treating “secondary bacterial pneumonia in critically ill patients with severe pneumonia, including those with Covid”.

“The team looked at records for 585 people admitted to the intensive care unit (ICU) at Northwestern Memorial Hospital, also in Illinois.

They all had severe pneumonia and/or respiratory failure, and 190 had Covid,” he said.

“Using a machine learning approach to crunch through the data, the researchers grouped patients based on their condition and the amount of time they spent in intensive care.

The findings refute the idea that a cytokine storm following Covid was responsible for a significant number of deaths.

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No multiorgan failure

There was no evidence of multiorgan failure in the patients studied.” Singer said instead, Covid patients were more likely to develop ventilator-associated pneumonia (VAP) and for longer periods and the cases where VAP did not respond to treatment were significant in terms of the overall mortality rates in the study.

“Those who were cured of their secondary pneumonia were likely to live, while those whose pneumonia did not resolve were more likely to die,” said Singer.

“Our data suggested that the mortality related to the virus itself is relatively low, but other things that happen during the ICU stay, like secondary bacterial pneumonia, offset that.”

Could this infection be a main contributor to many Covid deaths? SA private practitioner Dr Angelique Coetzee said it was a difficult situation and described it quite similar to the “egg or chicken” narrative.

Another pulmonologist at Northwestern, Catherine Gao, said the findings highlighted a need for further studies and to be cautious when assumptions were made about the cause of death in Covid cases.

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– lungas@citizen.co.za