Department of Medicine, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond, Virginia, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
Am J Gastroenterol. 2022 Nov 1;117(11):1874-1876. doi: 10.14309/ajg.0000000000001911. Epub 2022 Jul 21.
Nosocomial infections (NIs) in critically ill patients with cirrhosis result in higher death and transplant delisting. NIs are promoted by staff, visitors, and the environment, all of which were altered to reduce pathogen transmission after COVID-19. Two cohorts of intensive care unit patients with cirrhosis from March 2019 to February 2020 (pre-COVID, n = 234) and March 2020 to March 2021 (COVID era, n = 296) were included. We found that despite a higher admission MELD-Na, qSOFA, and WBC count and requiring a longer intensive care unit stay, COVID-era patients developed lower NIs (3% vs 10%, P < 0.001) and had higher liver transplant rates vs pre-COVID patients. COVID-era restrictions could reduce NIs in critically ill patients with cirrhosis.
肝硬化重症患者的医院感染（NIs）会导致更高的死亡率和移植剔除率。NIs 由医护人员、访客和环境等因素促进，这些因素在 COVID-19 之后都发生了改变，以减少病原体传播。纳入了 2019 年 3 月至 2020 年 2 月（COVID-19 前，n=234）和 2020 年 3 月至 2021 年 3 月（COVID 时代，n=296）期间的两组肝硬化重症监护病房患者。我们发现，尽管 COVID 时代患者的入院 MELD-Na、qSOFA 和白细胞计数更高，需要更长的重症监护病房停留时间，但他们的医院感染发生率更低（3% vs. 10%，P<0.001），且与 COVID-19 前患者相比，他们的肝移植率更高。COVID 时代的限制措施可能会减少肝硬化重症患者的医院感染。
