COVID-19 Infection and Late Manifestation of Pulmonary Aspergillosis

Bhopalwala, Huzefa; Mishra, Vinayak; Vi, Tuong; Gudipati, M.; Ganti, Subramanya Shyam

doi:10.1177/23247096211063332

Cited by 11 publications

(10 citation statements)

References 17 publications

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“…Since the data are collected based on administrative codes, it is not possible to establish whether a complication was present on admission or developed during the hospital stay. Rare complications of COVID-19 were not reported in this study [ 45 , 46 ]. Second, laboratory data and metrics like SOFA score, APACHE II, and SAPS III that have been validated to predict mortality in critically ill patients were not evaluated in our study [ 47 ].…”

Section: Discussionmentioning

confidence: 91%

Outcomes of Heart Failure in COVID-19 Patients: An Appalachian Experience

et al. 2022

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Background The Southeastern rural areas of the USA have a higher prevalence of heart failure (HF). Coronavirus disease 2019 (COVID-19) infection is associated with poor outcomes in patients with HF. Our study aimed to compare the outcomes of hospitalized HF patients with and without COVID-19 infection specifically in rural parts of the USA. Methods We conducted a retrospective cohort study of HF patients with and without COVID-19 hospitalized in Southeastern rural parts of the USA by using the Appalachian Regional Healthcare System. Analyses were stratified by waves from April 1, 2020 to May 31, 2021, and from June 1, 2021 to October 19, 2021. Results Of the 14,379 patients hospitalized with HF, 6% had concomitant COVID-19 infection. We found that HF patients with COVID-19 had higher mortality rate compared to those without COVID-19 (21.8% versus 3.8%, respectively, P < 0.01). Additionally, hospital resource utilization was significantly higher in HF patients with COVID-19 compared to HF patients without COVID-19 with intensive care unit (ICU) utilization of 21.6% versus 13.8%, P < 0.01, mechanical ventilation use of 17.3% versus 6.2%, P < 0.01, and vasopressor/inotrope use of 16.8% versus 7.9%, P < 0.01. A lower percentage of those with COVID-19 were discharged home compared to those without a COVID-19 diagnosis (63.4% versus 72.0%, respectively). There was a six-fold greater odds of dying in the first wave and seven-fold greater odds of dying in the second wave. Conclusions Our study confirms previous findings of poor outcome in HF patients with COVID-19. There is a need for review of healthcare resources in rural hospitals which already face numerous healthcare challenges.

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Section: Discussionmentioning

confidence: 91%

Outcomes of Heart Failure in COVID-19 Patients: An Appalachian Experience

et al. 2022

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“…As described in the study by Bhopalwala et al, a case of invasive pulmonary aspergillosis (IPA) that occurred after treatment of COVID-19 infection shows an increase in the probability of complications like IPA and ARDS with immunosuppression drug use [ 9 ]. Our patient developed hemoptysis one day after admission which is commonly seen in patients with necrotizing pneumonia.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and Cavitary Lesion in Lung

Vangara¹,

Rahmlow²,

Gullapalli³

et al. 2023

Cureus

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The clinical manifestations of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widespread, ranging from asymptomatic to critical illness with significant morbidity and mortality. It is widely known that individuals who have viral respiratory infections are more likely to develop bacterial infections. Throughout the pandemic, despite the fact that COVID-19 was thought to be the primary cause of millions of deaths, bacterial coinfections, superinfections, and other secondary complications played a significant role in the increased mortality rate. In our case, a 76-year-old male presented to the hospital complaining of shortness of air. Polymerase chain reaction (PCR) testing was positive for COVID-19 and cavitary lesions were discovered on imaging. Treatment was guided based on the results of bronchoscopy with bronchoalveolar lavage (BAL) cultures showing methicillin-resistant Staphylococcus aureus (MRSA) and Mycobacterium gordonae. However, the case was later complicated by the development of a pulmonary embolism after anticoagulants were held due to new onset hemoptysis. Our case highlights the importance of considering bacterial coinfection in cavitary lung lesions, appropriate antimicrobial stewardship, and close follow-up for full recovery in COVID-19 infections.

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“… 3 , 5 In Bhopalwala et al 11 study, they treated a patient who had COVID-19 with pulmonary aspergillosis with itraconazole due to insurance requirements and fewer side effects, and the patient’s symptoms improved. 11 Side effects of antifungals include liver injury and neuropathy. 5 - 7 Itraconazole can cause edema, heart failure, and hypertension while voriconazole can cause photosensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…2 Chronic cavitary pulmonary aspergillosis is generally treated with antifungals such as voriconazole, itraconazole, and posaconazole. 3,5 In Bhopalwala et al 11 study, they treated a patient who had COVID-19 with pulmonary aspergillosis with itraconazole due to insurance requirements and fewer side effects, and the patient's symptoms improved. 11 Side effects of antifungals include liver injury and neuropathy.…”

Section: Discussionmentioning

confidence: 99%

Chronic Pulmonary Aspergillosis Infection in Coal Workers Pneumoconiosis With Progressive Massive Fibrosis

Vangara

Gudipati

Chan

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Pneumoconiosis is associated with coal dust particles depositing within the lung causing nodules coalesce to form progressive massive fibrosis (PMF). Cavitary lesions can develop in these PMF areas for concerns of tuberculosis and aspergillosis. We present a 59-year-old patient who had coal workers pneumoconiosis and PMF presenting with chronic dyspnea and hemoptysis with an upper cavitary lesion noted on chest imaging. He notes dyspnea with walking very short distances with associated productive cough. He admits to occasional wheezing, paroxysmal dyspnea, hemoptysis, and orthopnea but denies chest pain. He is an everyday smoker. His physical examination was only remarkable for bronchial breath sounds. On review of his prior imaging, he had a right upper lobe infiltrate as far back as 2012. As the years progressed, a new cavitary lesion developed in the PMF area which progressively got larger with a thick wall and no eccentric region noted inside the cavity. Tuberculosis test was negative. He underwent a transbronchial biopsy with methenamine silver stain which showed acute angle branching and septation suggestive of Aspergillus species. He was diagnosed with pulmonary aspergillosis and treated with voriconazole for 1 year. With pneumoconiosis and evidence confirming aspergillosis, the presence of a new lung infiltration with progression into a cavitary lesion leads to a diagnosis of chronic cavitary pulmonary aspergillosis (CCPA). With follow-up imaging showing extensive lung fibrosis, he had chronic fibrosing pulmonary aspergillosis (CFPA), a late-stage manifestation of CCPA.

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COVID-19 Infection and Late Manifestation of Pulmonary Aspergillosis

Cited by 11 publications

References 17 publications

Outcomes of Heart Failure in COVID-19 Patients: An Appalachian Experience

Outcomes of Heart Failure in COVID-19 Patients: An Appalachian Experience

COVID-19 and Cavitary Lesion in Lung

Chronic Pulmonary Aspergillosis Infection in Coal Workers Pneumoconiosis With Progressive Massive Fibrosis

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