{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:42:59Z","timestamp":1762076579875,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taipei Veterans General Hospital","award":["V111C-050","V111B-024","MOST 109-2314-B-010-051-MY3"],"award-info":[{"award-number":["V111C-050","V111B-024","MOST 109-2314-B-010-051-MY3"]}]},{"name":"National Science and Technology Council, Taiwan","award":["V111C-050","V111B-024","MOST 109-2314-B-010-051-MY3"],"award-info":[{"award-number":["V111C-050","V111B-024","MOST 109-2314-B-010-051-MY3"]}]},{"name":"Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan","award":["V111C-050","V111B-024","MOST 109-2314-B-010-051-MY3"],"award-info":[{"award-number":["V111C-050","V111B-024","MOST 109-2314-B-010-051-MY3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This study explored the clinical outcomes and association of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in patients with severe coronavirus disease 2019 (COVID-19) infection who developed nosocomial pneumonia. Methods: This was a retrospective study conducted in a medical center in Taiwan. From May to September 2021, patients from four intensive care units were enrolled after SARS-CoV-2 was confirmed through quantitative polymerase chain reaction and all cases were compatible with the definitions of severe COVID-19 infection. Baseline characteristics, disease severity, clinical outcomes, and times of viral shedding were recorded. Results: A total of 72 patients were diagnosed as having severe COVID-19 infection and 30 developed nosocomial pneumonia, comprising hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). The patients with severe COVID-19 infection and concomitant HAP\/VAP had longer intensive care unit (ICU) stays and fewer ventilator-free days at Day 28. An independent risk factor for nosocomial pneumonia was a greater SOFA score at admission. Furthermore, the patients with severe COVID-19 infection who developed HAP\/VAP had a significantly longer duration of SARS-CoV-2 shedding (19.50 days vs. 15.00 days, p = 0.006). Conclusions: Patients with severe COVID-19 infection who developed nosocomial pneumonia had longer SARS-CoV-2 shedding days, more complications, and worse outcomes.<\/jats:p>","DOI":"10.3390\/jcm11226796","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T06:19:01Z","timestamp":1668665941000},"page":"6796","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Chuan-Yen","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Yih","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhong-Ru","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8637-2937","authenticated-orcid":false,"given":"Hisao-Chin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0585-8463","authenticated-orcid":false,"given":"Yuh-Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4172-5529","authenticated-orcid":false,"given":"Wei-Chih","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"},{"name":"Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2803-980X","authenticated-orcid":false,"given":"Kuang-Yao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"},{"name":"Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"},{"name":"Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3764","DOI":"10.1128\/IAI.00298-15","article-title":"Influenza and Bacterial Superinfection: Illuminating the Immunologic Mechanisms of Disease","volume":"83","author":"Robinson","year":"2015","journal-title":"Infect. 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