{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:22:38Z","timestamp":1790745758755,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,8]],"date-time":"2022-05-08T00:00:00Z","timestamp":1651968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Background: The coronavirus disease 2019 (COVID-19) pandemic has put significant pressure on hospitals and in particular on intensive care units (ICU). Some patients develop acute hypoxemic respiratory failure with profound hypoxia, which likely requires invasive mechanical ventilation during prolonged periods. Corticosteroids have become a cornerstone therapy for patients with severe COVID-19, though only little data are available regarding their potential harms and benefits, especially concerning the risk of a ventilator-associated lower respiratory tract infection (VA-LRTI). Methods: This retrospective multicenter study included patients admitted in four ICUs from Belgium and France for severe COVID-19, who required invasive mechanical ventilation (MV). We compared clinical and demographic variables between patients that received corticosteroids or not, using univariate, multivariate, and Fine and Gray analyses to identify factors influencing VA-LRTI occurrence. Results: From March 2020 to January 2021, 341 patients required MV for acute respiratory failure related to COVID-19, 322 of whom were included in the analysis, with 60.6% of them receiving corticosteroids. The proportion of VA-LRTI was significantly higher in the early corticosteroid group (63.1% vs. 48.8%, p = 0.011). Multivariable Fine and Gray modeling considering death and extubation as competing events revealed that the factors independently associated with VA-LRTI occurrence were male gender (adjusted sHR:1.7, p = 0.0022) and corticosteroids (adjusted sHR: 1.44, p = 0.022). Conclusions: in our multicenter retrospective cohort of COVID-19 patients undergoing MV, early corticosteroid therapy was independently associated with VA-LRTI.<\/jats:p>","DOI":"10.3390\/microorganisms10050984","type":"journal-article","created":{"date-parts":[[2022,5,8]],"date-time":"2022-05-08T21:31:20Z","timestamp":1652045480000},"page":"984","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Early Corticosteroid Therapy May Increase Ventilator-Associated Lower Respiratory Tract Infection in Critically Ill Patients with COVID-19: A Multicenter Retrospective Cohort Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8974-4991","authenticated-orcid":false,"given":"Jean-Baptiste","family":"Mesland","sequence":"first","affiliation":[{"name":"Critical Care Department, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Carlier","sequence":"additional","affiliation":[{"name":"Intensive Care, CHU-Charleroi Marie Curie, Universit\u00e9 Libre de Bruxelles, 6042 Charleroi, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"ICU Department and Inserm CIC 1435 & UMR 1092, CHU Dupuytren, 87000 Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5486-7812","authenticated-orcid":false,"given":"Nicolas","family":"Serck","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Soins Intensifs, Clinique Saint-Pierre, 1340 Ottignies, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Gerard","sequence":"additional","affiliation":[{"name":"Critical Care Department, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Briat","sequence":"additional","affiliation":[{"name":"ICU Department and Inserm CIC 1435 & UMR 1092, CHU Dupuytren, 87000 Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Piagnerelli","sequence":"additional","affiliation":[{"name":"Intensive Care, CHU-Charleroi Marie Curie, Universit\u00e9 Libre de Bruxelles, 6042 Charleroi, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Fran\u00e7ois","family":"Laterre","sequence":"additional","affiliation":[{"name":"Critical Care Department, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the COVCORVAP Collaboration Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S2213-2600(20)30161-2","article-title":"Intensive care management of coronavirus disease 2019 (COVID-19): Challenges and recommendations","volume":"8","author":"Phua","year":"2020","journal-title":"Lancet Respir. 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