2020
DOI: 10.1590/0037-8682-0401-2020
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Abstract: We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support. Histopathology and peripheral blood galactomannan antigen testing confirmed IPA. Aspergillus penicillioides infection was confirmed by nucleotide sequencing and BLAST analysis. Further reports are needed to assess the occurrence and frequency of IPA in SARS-CoV-2… Show more

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Cited by 60 publications
(74 citation statements)
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“…In conclusion, our findings indicate that the diagnosis of CAPA needs a strong correlation between clinical, radiographic and laboratory data [ 56 , 57 , 58 , 59 , 60 ], as the growth of Aspergillus or positive fungal biomarkers may not necessarily indicate invasive disease. High-risk patient groups need to be better defined, but administration of corticosteroids may be an important risk factor for CAPA.…”
Section: Discussionmentioning
confidence: 94%
“…In conclusion, our findings indicate that the diagnosis of CAPA needs a strong correlation between clinical, radiographic and laboratory data [ 56 , 57 , 58 , 59 , 60 ], as the growth of Aspergillus or positive fungal biomarkers may not necessarily indicate invasive disease. High-risk patient groups need to be better defined, but administration of corticosteroids may be an important risk factor for CAPA.…”
Section: Discussionmentioning
confidence: 94%
“…Another patient was diagnosed at post-mortem with histopathologic findings of fungal hyphae and spores in the lung tissue, further confirmed by nucleotide sequencing and identified as A. penicillioides . A stored peripheral blood sample revealed a GM ODI of 4.290 [ 15 ]. The other four proven cases were diagnosed by histopathological examination of the biopsy material taken from a bronchoscopy of the suspicious tracheobronchial lesions [ 13 ].…”
Section: Diagnosis Of Capamentioning
confidence: 99%
“…With the global spread of COVID-19, as of 30 June 2020, 38 cases of CAPA have been reported. [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Here, we review these cases of CAPA so as to highlight the diagnostic and therapeutic challenges posed by this novel fungal co-infection.…”
Section: Introductionmentioning
confidence: 99%
“…The disease spectrum in COVID-19 ranges from asymptomatic infection to severe illness with acute respiratory distress syndrome (ARDS) requiring critical care, with 20-40% of hospitalised symptomatic patients developing ARDS (10)(11)(12). An increasing number of anecdotal case reports and case series have identified COVID-19 associated pulmonary aspergillosis (CAPA) as an additional infective complication of COVID-19 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Depending on the study and the region of origin, reported incidence rates for CAPA ranged from approximately 5% (14) to 20-35% (17)(18)(19)(20)(21).…”
Section: Downloaded Frommentioning
confidence: 99%
“…in the absence of other positive biomarkers should be interpreted with a degree of caution (23). Finally, due to fears surrounding potential aerosol generation during autopsy, post-mortem proof of fungal infection to substantiate putative cases of CAPA is absent in all but very rare reports (22). Due to the above limitations, the diagnosis of a substantial proportion of the putative cases of CAPA reported to date (10/35) on November 6, 2020 by guest http://jcm.asm.org/ Downloaded from has been based solely upon recovery of Aspergillus spp.…”
Section: Downloaded Frommentioning
confidence: 99%