Healthcare-associated infections in the Intensive Care Unit during the COVID-19 pandemic

Abstract Objective: To describe the occurrence of healthcare-associated infections in the first and second waves of the COVID-19 pandemic and analyze their correlations with management indicators in an intensive care unit. Methods: Retrospective documentary study conducted during the epidemiological waves of the COVID-19 pandemic using the database of patients admitted to the intensive care unit of a private hospital in São Paulo. Inclusion criteria comprised patients admitted between March 2020 and August 2021, aged over 18 years, diagnosed with COVID-19, and presenting healthcare-associated infections. Descriptive analysis was performed for demographic and clinical variables, and Pearson’s chi-square and Fisher’s exact tests were used for associations. A significance level of 5% was considered in the analyzes. Results: Ventilator-associated pneumonia is highlighted as the most prevalent topography among infections. A considerable increase in infection rates and use of invasive devices were also observed from the first to the second wave, as well as a positive correlation between infections and bed/day and patient/day occupancy indicators. Conclusion: Infections and the use of invasive devices increased from the first to the second wave of COVID-19, as well as the occurrence of adverse events related to care between the periods. The increase in the number of beds, hospitalizations and occupancy also showed a positive impact on the increase in infections in the unit.