scholarly journals Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients

2022 ◽  
Vol 8 (1) ◽  
pp. 58
Author(s):  
Kerri Basile ◽  
Catriona Halliday ◽  
Jen Kok ◽  
Sharon C-A. Chen
Keyword(s):  
Invasive Aspergillosis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Delayed Diagnosis ◽  
Invasive Fungal Disease ◽  
Pulmonary Aspergillosis ◽  
Poor Outcomes ◽  
Endemic Mycoses

Invasive fungal disease (IFD) associated with Coronavirus Disease 2019 (COVID-19) has focussed predominantly on invasive pulmonary aspergillosis. However, increasingly emergent are non-Aspergillus fungal infections including candidiasis, mucormycosis, pneumocystosis, cryptococcosis, and endemic mycoses. These infections are associated with poor outcomes, and their management is challenged by delayed diagnosis due to similarities of presentation to aspergillosis or to non-specific features in already critically ill patients. There has been a variability in the incidence of different IFDs often related to heterogeneity in patient populations, diagnostic protocols, and definitions used to classify IFD. Here, we summarise and address knowledge gaps related to the epidemiology, risks, diagnosis, and management of COVID-19-associated fungal infections other than aspergillosis.

scholarly journals Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19

2020 ◽  
Vol 8 (6) ◽  
pp. e48-e49 ◽  
Author(s):  
Alexandre Alanio ◽  
Sarah Dellière ◽  
Sofiane Fodil ◽  
Stéphane Bretagne ◽  
Bruno Mégarbane
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis

scholarly journals Management of invasive pulmonary aspergillosis in non-neutropenic critically ill patients

2007 ◽  
Vol 33 (10) ◽  
pp. 1694-1703 ◽  
Author(s):  
R. J. Trof ◽  
A. Beishuizen ◽  
Y. J. Debets-Ossenkopp ◽  
A. R. J. Girbes ◽  
A. B. J. Groeneveld
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis

scholarly journals Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: results from the prospective AspCOVID-19 study

2020 ◽  
Author(s):  
Tobias Lahmer
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Early Stage ◽  
Invasive Pulmonary Aspergillosis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Pulmonary Aspergillosis ◽  
Time Period ◽  
Incidence Risk ◽  
Standardized Screening

Background: Superinfections, including invasive pulmonary aspergillosis (IPA), are well-known complications of critically ill patients with severe viral pneumonia. Aim of this study was to evaluate the incidence, risk factors and outcome of IPA in critically ill patients with severe COVID-19 pneumonia. Methods: We prospectively screened 32 critically ill patients with severe COVID-19 pneumonia for a time period of 28 days using a standardized study protocol for oberservation of developement of COVID-19 associated invasive pulmonary aspergillosis (CAPA). We collected laboratory, microbiological, virological and clinical parameters at defined timepoints in combination with galactomannan-antigen-detection from bronchial aspirates. We used logistic regression analyses to assess if COVID-19 was independently associated with IPA and compared it with matched controls. Findings: CAPA was diagnosed at a median of 4 days after ICU admission in 11/32 (34%) of critically ill patients with severe COVID-19 pneumonia as compared to 8% in the control cohort. In the COVID-19 cohort, mean age, APACHE II score and ICU mortality were higher in patients with CAPA than in patients without CAPA (36% versus 9.5%; p<0.001). ICU stay (21 versus 17 days; p=0.340) and days of mechanical ventilation (20 versus 15 days; p=0.570) were not different between both groups. In regression analysis COVID-19 and APACHE II score were independently associated with IPA. Interpretation: CAPA is highly prevalent and associated with a high mortality rate. COVID-19 is independently associated with invasive pulmonary aspergillosis. A standardized screening and diagnostic approach as presented in our study can help to identify affected patients at an early stage.

scholarly journals High prevalence of putative invasive pulmonary aspergillosis in critically ill COVID-19 patients

2020 ◽  
Author(s):  
Alexandre Alanio ◽  
Sarah Dellière ◽  
Sofiane Fodil ◽  
Stéphane Bretagne ◽  
Bruno Mégarbane
Keyword(s):  
Invasive Aspergillosis ◽  
Critically Ill ◽  
Lung Inflammation ◽  
Invasive Pulmonary Aspergillosis ◽  
High Dose ◽  
Pulmonary Aspergillosis ◽  
High Prevalence ◽  
Almost All ◽  
Immunomodulatory Therapies ◽  
To Receive

AbstractWe are currently facing a frightening increase in COVID-19 patients admitted to the ICU. Aiming at screening for fungal secondary pneumonia, we collected the data of our first 27 ICU patients, who underwent bronchoalveolar lavage or bronchial aspirates. We classified the patients based on the recently published study on invasive aspergillosis in influenza patients (Schauwvlinghe et al., 2018.) and found 33% of our COVID-19 patients with putative invasive pulmonary aspergillosis. Observing such a high prevalence in COVID-infected patients was somehow unexpected since the 30% prevalence of invasive aspergillosis in influenza patients has been attributed to the action of oseltamivir on anti-Aspergillus immunity. Almost all critically ill COVID-19 patients develop ARDS and are likely to receive high-dose steroids or immunomodulatory therapies to prevent worsening as suggested by reports from China. In the COVID-19 patients with putative invasive aspergillosis, antifungal prophylactic therapy may be questioned to avoid increased lung inflammation that may compromise the outcome. This issue remains to be addressed in future clinical trials. We are strongly convinced that testing deep lung specimens for Aspergillus in severe COVID-19 patients should be recommended.

Usefulness of ICU criteria for diagnosis of invasive pulmonary aspergillosis in nonhematologic critically ill patients

2019 ◽  
Vol 58 (3) ◽  
pp. 275-281
Author(s):  
Song-I Lee ◽  
Heungsup Sung ◽  
Sang-Bum Hong ◽  
Chae-Man Lim ◽  
Younsuck Koh ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Hematologic Malignancy ◽  
Invasive Pulmonary Aspergillosis ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Pulmonary Aspergillosis ◽  
Treatment Groups ◽  
Significant Difference ◽  
Criteria For Diagnosis

Abstract Invasive pulmonary aspergillosis (IPA) is a life-threatening disease in the intensive care unit (ICU). The ICU criteria were proposed to diagnose IPA in critically ill patients. This study aims to evaluate the usefulness of ICU criteria for diagnosis and treatment of IPA in nonhematologic patients in the ICU. We retrospectively reviewed 103 ICU patients with positive galactomannan test in blood and respiratory tract from January 1, 2016, to May 31, 2017. We excluded patients with hematologic malignancy. We divided the treatment and non-treatment groups according to the IPA treatment. We compared the baseline characteristics and outcomes between two groups and the agreement with ICU criteria. There were 49 patients in treatment groups and 54 patients in non-treatment groups. There were more cases of solid organ transplantation (P = .003), immunosuppressive therapy (P &lt; .001) and bacterial viral coinfection (P = .048) in the treatment group compared to nontreatment group. There was no statistically significant difference in mortality, the use of ventilator, and septic shock between the two groups. The agreement rate between the putative group and treatment was low (59.2%). There was no statistically significant difference in outcome between the putative and colonization groups according to the ICU criteria in each group. The treatment of IPA based on the symptom, radiologic finding and galactomannan test did not showed the better outcome. Also, the treatment based on the ICU criteria didn’t show the difference of outcome. The new criteria for diagnosis of IPA in critically ill patients are needed.

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