Invasive pulmonary aspergillosis in COVID-19. A case series at Gregorio Maranon University General Hospital

Purpose: Patients with acute respiratory distress syndrome (ARDS) due to viral infection admitted at ICU are at risk for secondary complications like invasive pulmonary aspergillosis. Our study evaluates severe ARDS due to COVID-19 associated invasive pulmonary aspergillosis at a single center in Madrid, Spain. Materials and Methods: A retrospective chart review of patients with COVID-19 associated ARDS admitted to two of the five ICUs that were available at the Gregorio Maranon University General Hospital, Madrid, Spain. Results: COVID-19 associated invasive pulmonary aspergillosis was found in 4 of 79 critically ill patients with severe ARDS. Conclusion: Patients with ARDS triggered by COVID-19 seem to be at risk of developing invasive pulmonary aspergillosis, being necessary the early diagnosis and treatment in order to improve their prognosis.

Descripción y seguimiento de pacientes COVID-19 en ventilación mecánica en unidades convertidas dirigidas por anestesiólogos: Clínica Alemana de Santiago

Introduction: The high demand for critical care beds and the need for mechanical ventilation generated by the pandemia of COVID-19 led the Ministry of Health of Chile to authorize both the conversion of beds and the use of anesthesia machines to mechanically ventilate COVID-19 patients. At Clínica Alemana de Santiago (CAS), these converted units were managed by non-intensivist anesthesiologists with technical support from the Intensive Care Unit (ICU). The objective of this study was to compare the survival rate of patients managed at converted and traditional ICU units. The secondary objective was to analyze the factors that may affect morbidity and mortality of these patients. Method: This prospective observational study included mechanically ventilated COVID-19 patients in both traditional and converted units. Patients were followed for 90 days starting at intubation day. Survival rate was determined at 30 and 90 days. A survival analysis was then performed. Results: 41 and 42 patients were admitted to CAS trough converted and traditional ICU units, respectively, between May 24 and June 30, 2020. There was not significant difference in survival rate between converted and traditional ICU units. Age (HR 1.1 per year) and SOFA (HR 1.4 per point) were associated with survival. Conclusions: At CAS, the survival of COVID-19 patients who required mechanical ventilation in converted units was not different as in those patients treated in traditional ICU units. Both age and SOFA were variables that can inform about prognosis of these patients.