COVID-19 associated pulmonary aspergillosis (CAPA) in a pregnant woman

Agrawal, Shree; Phulware, Ravi Hari

doi:10.4322/acr.2021.313

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Although serum GM for CAPA diagnosis may produce false‐positive results, occasionally related to the prescription of nutritional supplements containing Bifidobacterium , 22 positive results may be related to angioinvasion that has been reported in some CAPA cases. 23 , 24 Therefore, serum GM may be useful for the diagnosis of CAPA if requested in scenarios of high pre‐test probability in patients without ongoing known risk factors for false‐positive results.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19‐associated aspergillosis in a Brazilian referral centre: Diagnosis, risk factors and outcomes

Almeida

Doi

Watanabe

et al. 2022

Mycoses

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Background COVID‐19 patients on mechanical ventilation are at risk to develop invasive aspergillosis. To provide additional data regarding this intriguing entity, we conducted a retrospective study describing risk factors, radiology and prognosis of this emerging entity in a Brazilian referral centre. Methods This retrospective study included intubated (≥18 years) patients with COVID‐19 admitted from April 2020 until July 2021 that had bronchoscopy to investigate pulmonary co‐infections. COVID‐19‐associated aspergillosis (CAPA) was defined according to the 2020 European Confederation of Medical Mycology/International Society of Human and Animal Mycosis consensus criteria. The performance of tracheal aspirate (TA) cultures to diagnose CAPA were described, as well as the radiological findings, risk factors and outcomes. Results Fourteen patients (14/87, 16%) had probable CAPA (0.9 cases per 100 ICU admissions). The sensitivity, specificity, positive predictive value and negative predictive value of TA for the diagnosis of CAPA were 85.7%, 73.1%, 46.2% and 95% respectively. Most of the radiological findings of CAPA were classified as typical of invasive pulmonary aspergillosis (64.3%). The overall mortality rate of probable CAPA was 71.4%. Age was the only independent risk factor for CAPA [p = .03; odds ratio (OR) 1.072]. CAPA patients under renal replacement therapy (RRT) may have a higher risk for a fatal outcome (p = .053, hazard ratio 8.047). Conclusions CAPA was a prevalent co‐infection in our cohort of patients under mechanical ventilation. Older patients had a higher risk to develop CAPA, and a poor prognosis may be associated with RRT.

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Section: Discussionmentioning

confidence: 99%