Comparison of clinical features and outcomes in COVID-19 and influenza pneumonia patients requiring intensive care unit admission

Oliva, Alessandra; Ceccarelli, Giancarlo; Borrazzo, Cristian; Ridolfi, Marco; Ettorre, Giuseppe; Alessandri, Francesco; Ruberto, Franco; Pugliese, Francesco; Raponi, Giammarco; Russo, Alessandro; Falletta, Antonio; Mastroianni, Claudio Maria; Venditti, Mario

doi:10.1007/s15010-021-01624-7

Cited by 21 publications

(24 citation statements)

References 50 publications

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“…Our ndings con rm current evidence showing higher mortality and morbidity in SARS-CoV-2 compared to seasonal in uenza [17][18][19][20][21][22] . We have previously shown that elevated PAPsys, most probably due to elevated pulmonary vascular resistance, caused by alveolar and vascular damage, leads to RV-distress in COVID-19.…”

Section: Discussionsupporting

confidence: 89%

COVID-19 Versus Seasonal Influenza: Myocardial Injury And Prognostic Importance

Mizera

Zdanytė

Gernert

et al. 2022

Preprint

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Background: Acute myocardial injury is associated with poor prognosis in respiratory tract infections. We aimed to highlight the differences in prevalence of myocardial injury and its impact on prognosis in patients with COVID-19 compared to those with seasonal influenza. Methods: This was a single-center prospective cohort study with a historical control group. 300 age-/sex-matched SARS-CoV-2 and seasonal influenza positive patients were enrolled. Myocardial injury was assessed by electrocardiogram (ECG), transthoracic echocardiography and biomarkers including high-sensitivity troponin-I. All patients were followed-up for 30 days after enrollment for all-cause mortalitiy, admission to the intensive care unit (ICU) and mechanical ventilation.Results: Right ventricular distress was more common in COVID-19 whereas pathological ECG findings and impaired left ventricular function were more prevalent among influenza patients. COVID-19 patients suffered from a higher percentage of hypertension and dyslipidaemia. Contrary to COVID-19, pericardial effusion at admission was associated with poor outcome in the influenza group. Severe course of disease and respiratory failure resulted in significantly higher rates of ICU treatment and mechanical ventilation in COVID-19 patients. Although distribution of myocardial injury was similar, significantly fewer cardiac catheterizations were performed in COVID-19 patients. However, number of cardiac catheterizations was low in both groups. Finally, 30-day mortality was significantly higher in COVID-19 compared to influenza patients.Conclusions: In adults requiring hospitalization due to COVID-19 or seasonal influenza, cardiovascular risk factors and signs of myocardial distress differ significantly. Furthermore, cardiovascular comorbidities may impair prognosis in COVID-19 patients to a higher degree than in their influenza counterparts.

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Section: Discussionsupporting

confidence: 89%

COVID-19 Versus Seasonal Influenza: Myocardial Injury And Prognostic Importance

Mizera

Zdanytė

Gernert

et al. 2022

Preprint

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“…[ 23 ]; [ 24 ]; [ 25 ]; [ 26 ]; [ 27 ]; [ 28 ]; [ 29 ]; [ 30 ]; [ 31 ]; [ 32 ]; [ 33 ]; [ 34 ]; [ 35 ]; [ 36 ]; [ 37 ]; [ 38 ]; [ 39 ]; [ 40 ]; [ 41 ]; [ 42 ]; [ 43 ]; [ 44 ]; [ 45 ]; [ 46 ]; [ 47 ]; [ 48 ]; [ 49 ]; [ 50 ]; [ 51 ]; [ 52 ]; [ 53 ]; [ 54 ]; [ 55 ]; [ 56 ]; [ 57 ]; [ 58 ]; [ 59 ]; [ 60 ]; [ 61 ]; [ 62 ]; [ 63 ]; [ 64 ]; [ 65 ]; [ 66 ]; [ 67 ]; [ 68 ]; [ 69 ].…”

Section: Uncited Referencesunclassified

Defining COVID-19–associated pulmonary aspergillosis: systematic review and meta-analysis

Kariyawasam

Dingle

Kula

et al. 2022

Clinical Microbiology and Infection

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Background Pulmonary aspergillosis may complicate COVID-19 and contribute to excess mortality in intensive care unit (ICU) patients. The disease is poorly understood, in part due to discordant definitions across studies. Objectives We sought to review the prevalence, diagnosis, treatment, and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA) and compare research definitions. Methods . Data Sources PubMed, Embase, Web of Science, and MedRxiv were searched from inception to October 12, 2021. Study eligibility criteria ICU cohort studies and CAPA case series including ≥3 patients were included. Participants Adult patients in ICUs with COVID-19. Definitions Patients were reclassified according to 4 research definitions (respectively described by Verweij et al, White et al, Koehler et al, and Bassetti et al). Assessment of risk of bias We assessed risk of bias with an adaptation of the Joanna Briggs Institute cohort checklist tool for systematic reviews. Methods of data synthesis We calculated CAPA prevalence using Freeman-Tukey random effects method. Correlations between definitions were assessed with Spearman’s rank test. Associations between antifungals and outcome were assessed with random effects meta-analysis. Results 51 studies were included. Among 3,297 COVID-19 patients in ICU cohort studies, 313 were diagnosed with CAPA (prevalence 10%, 95% confidence interval 8-13%). 277 patients had patient-level data allowing reclassification. Definitions had limited correlation with one another (ρ=0.268 to 0.447, p<0.001) with the exception of Koehler and Verweij (ρ=0.893, p<0.001). 33.9% of patients reported to have CAPA did not fulfill any research definitions. Patients were diagnosed after a median of 8 days (interquartile range 5-14) in ICUs. Tracheobronchitis occurred in 3% of patients examined with bronchoscopy. The mortality rate was high (59.2%). Applying CAPA research definitions did not strengthen the association between mould-active antifungals and survival. Conclusions The reported prevalence of CAPA is significant, but may be exaggerated by non-standard definitions.

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“…The maps on the right show the pooled CAPA incidence per country in studies with observational data. Only studies with exact information on the countries where patients were recruited were included in this figure [2,9,15,16,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38]40,41,[43][44][45][47][48][49][51][52][53][54][55][56][57][58][59]. CAPA incidence is calculated per study for the combination of proven, probable, putative and possible CAPA cases.…”

Section: Incidencementioning

confidence: 99%

A Visual and Comprehensive Review on COVID-19-Associated Pulmonary Aspergillosis (CAPA)

Feys

Almyroudi

Braspenning

et al. 2021

JoF

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Coronavirus disease 19 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe fungal infection complicating critically ill COVID-19 patients. Numerous retrospective and prospective studies have been performed to get a better grasp on this lethal co-infection. We performed a qualitative review and summarized data from 48 studies in which 7047 patients had been included, of whom 820 had CAPA. The pooled incidence of proven, probable or putative CAPA was 15.1% among 2953 ICU-admitted COVID-19 patients included in 18 prospective studies. Incidences showed great variability due to multiple factors such as discrepancies in the rate and depth of the fungal work-up. The pathophysiology and risk factors for CAPA are ill-defined, but therapy with corticosteroids and anti-interleukin-6 therapy potentially confer the biggest risk. Sampling for mycological work-up using bronchoscopy is the cornerstone for diagnosis, as imaging is often aspecific. CAPA is associated with an increased mortality, but we do not have conclusive data whether therapy contributes to an increased survival in these patients. We conclude our review with a comparison between influenza-associated pulmonary aspergillosis (IAPA) and CAPA.

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Comparison of clinical features and outcomes in COVID-19 and influenza pneumonia patients requiring intensive care unit admission

Cited by 21 publications

References 50 publications

COVID-19 Versus Seasonal Influenza: Myocardial Injury And Prognostic Importance

COVID-19 Versus Seasonal Influenza: Myocardial Injury And Prognostic Importance

Defining COVID-19–associated pulmonary aspergillosis: systematic review and meta-analysis

A Visual and Comprehensive Review on COVID-19-Associated Pulmonary Aspergillosis (CAPA)

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