COVID-19-associated invasive pulmonary aspergillosis

Rutsaert, Lynn; Steinfort, Nicky; Hunsel, Tine Van; Bomans, Peter; Naesens, Reinout; Mertes, Helena; Dits, H.; Regenmortel, N. Van

doi:10.1186/s13613-020-00686-4

Cited by 204 publications

(255 citation statements)

References 8 publications

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“…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 ]. However, most patients with severe COVID-19 pneumonia are usually critically ill and hemodynamically unstable, which will preclude performing invasive procedures, such as bronchoscopy with a lavage or a lung biopsy.…”

Section: Diagnosis Of Capamentioning

confidence: 99%

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COVID-19 Associated Invasive Pulmonary Aspergillosis: Diagnostic and Therapeutic Challenges

Mohamed

Rogers

Talento

2020

JoF

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Aspergillus co-infection in patients with severe coronavirus disease 2019 (COVID-19) pneumonia, leading to acute respiratory distress syndrome, has recently been reported. To date, 38 cases have been reported, with other cases most likely undiagnosed mainly due to a lack of clinical awareness and diagnostic screening. Importantly, there is currently no agreed case definition of COVID-19 associated invasive pulmonary aspergillosis (CAPA) that could aid in the early detection of this co-infection. Additionally, with the global emergence of triazole resistance, we emphasize the importance of antifungal susceptibility testing in order to ensure appropriate antifungal therapy. Herein is a review of 38 published CAPA cases, which highlights the diagnostic and therapeutic challenges posed by this novel fungal co-infection.

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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%

COVID-19 Associated Invasive Pulmonary Aspergillosis: Diagnostic and Therapeutic Challenges

Mohamed

Rogers

Talento

2020

JoF

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“…The frequency of CAPA ranged from 35% [ 9 ] to 3.8% [ 10 ] of all ICU patients with COVID-19. In comparison, the rate of influenza-associated (model post-viral) pulmonary aspergillosis (IAPA) is estimated between 16% and 23%.…”

Section: Epidemiologymentioning

confidence: 99%

“…was not investigated. In the study by Rutsaert et al [ 9 ], an environmental source was ruled out by sampling room air and the oxygen and pressurized air supplies. In addition, high-efficiency particulate air filters were installed in the ICU.…”

Section: Epidemiologymentioning

confidence: 99%

Invasive Pulmonary Aspergillosis in Patients with SARS-CoV-2 Infection: A Systematic Review of the Literature

et al. 2020

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In this systematic review, we investigate the epidemiology, pathogenesis, risk factors, clinical manifestations, diagnosis and treatment of COVID-19-associated pulmonary aspergillosis (CAPA). We identified 85 cases from 22 studies. The frequency of CAPA is currently unknown but ranges between <5% to >30% in different case series; the possibility of colonization rather than invasive disease is the most important confounder. The vast majority of patients with CAPA did not have any of the classic host risk factors, such as immunosuppression from organ transplant or neutropenia, although a significant proportion (46%) had received corticosteroids. Age, pulmonary comorbidities and male sex were associated with higher mortality. Patients treated with voriconazole had numerically lower case-fatality rate. Clinical vigilance for CAPA is advisable in critically ill patients with COVID-19 who are not improving, even those who do not meet classic host criteria for invasive mycoses, especially if they are receiving corticosteroids. A thorough, multi-faceted diagnostic work-up and early initiation of a mold-active triazole may be lifesaving. Further research studies using standardized, uniform definitions of invasive disease and colonization are urgently needed.

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“…Even more challenging is the diagnosis of fungal infections in patients with Covid-19, with most of the infections being associated with Candida and Aspergillus species [1,2]. Indeed, coronavirus-associated pulmonary aspergillosis (CAPA) is a concern in Covid-19 patients, occurring in 20-35% of patients with severe acute respiratory syndrome (SARS), mainly in those requiring admission to the intensive care unit (ICU) and mechanical ventilation [1,5,6]. Similarly, candidemia occurrs in 2.5% to 6.9% of Covid-19 patients in the ICU, mainly catheter-related infections and often with unfavorable outcomes [7,8].…”

Section: Introductionmentioning

confidence: 99%