CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis

Hong, Wonju; White, P. Lewis; Backx, Matthijs; Gangneux, Jean‐Pierre; Reizine, Florian; Köehler, Philipp; Bentvelsen, Robbert G.; Cuestas, María Luján; Fakhim, Hamed; Jung, Jung Im; Lee, Young Kyung; Dalsania, Nishil; Patti, Ravikaran; Yoon, Soon Ho

doi:10.1016/j.clinimag.2022.07.003

Cited by 9 publications

(7 citation statements)

References 42 publications

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“…However, it is now known that COVID-19 pneumonia may present with radiological features like those of CAPA, and vice versa, so typical radiological signs of CAPA may go unrecognized. For an appropriate diagnosis of CAPA, it will be necessary to consider that many cases of CAPA may occur without clear radiological evidence and overlap with CT scans with typical or indeterminate appearance for COVID-19 [ 8 , 22 , 23 ].…”

Section: Case Series and Discussionmentioning

confidence: 99%

COVID-19-associated pulmonary aspergillosis in intensive care unit: A real-life experience

Russo,

Serraino,

Serapide

et al. 2024

Heliyon

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Section: Case Series and Discussionmentioning

confidence: 99%

COVID-19-associated pulmonary aspergillosis in intensive care unit: A real-life experience

Russo,

Serraino,

Serapide

et al. 2024

Heliyon

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“…Аспергиллез легких (АЛ) -одно из наиболее распространенных жизнеугрожающих грибковых заболеваний, поражает все отделы дыхательной системы, вызывается вдыханием спор плесени Aspergillus spp., которые являются наиболее распространенными грибковыми микроорганизмами, ответственными за вторичные легочные инфекции [4,5]. Недавно опубликованные данные свидетельствуют о том, что АЛ развивается как осложнение после перенесенного COVID-19, особенно у пациентов, находящихся в ОИТ, способствуя повышению смертности [6,7].…”

Section: аспергиллез легких как осложнение перенесенной Covid-19-инфе...unclassified

“…Также было показано, что симптомы "венца" и "обратного венца" не имеют диагностического значения для оценки присоединения грибковой инфекции, так как теряются на фоне типичных для самого COVID-19 симптомов "обратного венца" и "матового стекла" разной степени выраженности [5]. Интересно, что 37% пациентов с COVID-АЛ не имели никаких дополнительных КТ-признаков присоединившейся грибковой инфекции [5]. Атипичные проявления новой коронавирусной инфекции наблюдались на КТ-изображениях в 40% случаев COVID-АЛ.…”

Section: кт-признаки Covid-19 ассоциированного аспергиллеза легкихunclassified

“…Авторы выяснили, что инвазивный легочный аспергиллез у пациентов с иммуносупрессией чаще демонстрирует ангиоинвазивный паттерн, чем паттерн повреждения дыхательных путей. В случаях COVID-АЛ наблюдается обратная картина: повреждение дыхательных путей наблюдалось у 57,1% пациентов, в то время как признаки ангиоинвазивного АЛ были выявлены только у 7,1% [5].…”

Section: кт-признаки Covid-19 ассоциированного аспергиллеза легкихunclassified

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Possibilities of CT in the diagnosis of pulmonary aspergillosis in patients with COVID-19 (literature review)

Nay,

Yudin,

Abovich

2023

Medicinskaâ vizualizaciâ

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Aim: to analyze the latest research in the field of CT diagnostics of pulmonary aspergillosis in patients with COVID-19 according to domestic and foreign literature.Results. Pulmonary aspergillosis is one of the most common life-threatening fungal diseases that is caused by inhalation of Aspergillus mold spores and affects all parts of the respiratory system. In recent years, there has been a sharp increase in cases of invasive mycotic processes. During the COVID-19 pandemic, according to a number of authors, the incidence of pulmonary aspergillosis reached 34.4%, and the mortality rate was 74%. The World Health Organization calls for “minimizing the disproportionate use of corticosteroids and antibiotics for mild and moderate cases”. She explained that corticosteroids in severe cases do save lives, but their massive use can cause fungal infections. This complication is increasingly common in patients after corticosteroid and antibiotic therapy, with immunodeficiency states, as well as those treated in intensive care units. The COVID-19 pandemic has created additional challenges in the diagnosis, treatment and prevention of fungal complications. The clinical and radiographic features of fungal infections are largely similar to typical pulmonary manifestations of COVID-19. A comparative analysis of CT signs of various forms of pulmonary aspergillosis before and during the COVID-19 pandemic was carried out according to the literature. The main CT symptoms of mycotic lung lesions among patients who have undergone COVID-19 have been identified. Currently, computed tomography is crucial, first of all, to detect and monitor complications of COVID-19, including the addition of a secondary fungal infection.Conclusion. To make a conclusion about mycosis in the early stages, special vigilance and high qualification of the radiologist are required, which in turn will contribute to the timely appointment of antifungal therapy, which will reduce morbidity and mortality.

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“…Diagnosis remains challenging due to the lack of strong consensus definitions and because clinical and radiological findings can mimic those of severe COVID-19 [ 5 , 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for COVID-19 associated pulmonary aspergillosis and outcomes in patients with acute respiratory failure in a respiratory sub-intensive care unit

Iacovelli,

Oliva,

Mirabelli

et al. 2024

BMC Infect Dis

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Background COVID-19-associated pulmonary aspergillosis (CAPA) is burdened by high mortality. Data are lacking about non-ICU patients. Aims of this study were to: (i) assess the incidence and prevalence of CAPA in a respiratory sub-intensive care unit, (ii) evaluate its risk factors and (iii) impact on in-hospital mortality. Secondary aims were to: (i) assess factors associated to mortality, and (ii) evaluate significant features in hematological patients. Materials and methods This was a single-center, retrospective study of COVID-19 patients with acute respiratory failure. A cohort of CAPA patients was compared to a non-CAPA cohort. Among patients with CAPA, a cohort of hematological patients was further compared to another of non-hematological patients. Results Three hundred fifty patients were included in the study. Median P/F ratio at the admission to sub-intensive unit was 225 mmHg (IQR 155–314). 55 (15.7%) developed CAPA (incidence of 5.5%). Eighteen had probable CAPA (37.3%), 37 (67.3%) possible CAPA and none proven CAPA. Diagnosis of CAPA occurred at a median of 17 days (IQR 12–31) from SARS-CoV-2 infection. Independent risk factors for CAPA were hematological malignancy [OR 1.74 (95%CI 0.75–4.37), p = 0.0003], lymphocytopenia [OR 2.29 (95%CI 1.12–4.86), p = 0.02], and COPD [OR 2.74 (95%CI 1.19–5.08), p = 0.014]. Mortality rate was higher in CAPA cohort (61.8% vs 22.7%, p < 0.0001). CAPA resulted an independent risk factor for in-hospital mortality [OR 2.92 (95%CI 1.47–5.89), p = 0.0024]. Among CAPA patients, age > 65 years resulted a predictor of mortality [OR 5.09 (95% CI 1.20–26.92), p = 0.035]. No differences were observed in hematological cohort. Conclusion CAPA is a life-threatening condition with high mortality rates. It should be promptly suspected, especially in case of hematological malignancy, COPD and lymphocytopenia.

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CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis

Cited by 9 publications

References 42 publications

COVID-19-associated pulmonary aspergillosis in intensive care unit: A real-life experience

COVID-19-associated pulmonary aspergillosis in intensive care unit: A real-life experience

Possibilities of CT in the diagnosis of pulmonary aspergillosis in patients with COVID-19 (literature review)

Risk factors for COVID-19 associated pulmonary aspergillosis and outcomes in patients with acute respiratory failure in a respiratory sub-intensive care unit

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