Although COVID-19 is no longer considered a global health emergency by the World Health Organization, researchers are still working to understand more about the virus and its impact on the body. A new analysis of data from 585 patients admitted to the ICU at Northwestern Memorial Hospital has found that a high percentage of those who required a ventilator due to a COVID-19 infection also developed secondary bacterial pneumonia. This pneumonia was responsible for a higher mortality rate than the COVID-19 infection itself.
The researchers used a machine learning approach to group patients based on their condition and the amount of time spent in intensive care. The findings refute the idea that a cytokine storm following COVID-19 was responsible for a significant number of deaths. Instead, COVID-19 patients were more likely to develop ventilator-associated pneumonia (VAP) and for longer periods. Cases where VAP did not respond to treatment were significant in terms of overall mortality rates in the study.
“Our study highlights the importance of preventing, looking for, and aggressively treating secondary bacterial pneumonia in critically ill patients with severe pneumonia, including those with COVID-19,” says Benjamin Singer, a pulmonologist at Northwestern University in Illinois. The results suggest that ICU outcomes could be improved if there were better strategies to diagnose and treat VAP episodes.
The study also highlights the potential of machine learning and artificial intelligence in clinical data analysis. “The application of machine learning and artificial intelligence to clinical data can be used to develop better ways to treat diseases like COVID-19 and to assist ICU physicians managing these patients,” says Catherine Gao, also a pulmonologist at Northwestern.
It is important to note that a patient’s requirement for a ventilator to treat COVID-19 complications leading to VAP does not imply that a COVID-19 infection is less dangerous or decrease the number of COVID-19 fatalities. The findings emphasize the need for caution when making assumptions about the cause of death in COVID-19 cases and the importance of further study. A detailed molecular analysis from the same study should reveal more about what makes the difference between recovering or not from VAP.
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