Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data from 186 patients who had coronavirus disease-associated pulmonary aspergillosis (CAPA) worldwide during March-August 2020. Overall, 182 patients were admitted to the intensive care unit (ICU), including 180 with acute respiratory distress syndrome and 175 who received mechanical ventilation. CAPA was diagnosed a median of 10 days after coronavirus disease diagnosis. Aspergillus fumigatus was identifi ed in 80.3% of patient cultures, 4 of which were azole-resistant. Most (52.7%) patients received voriconazole. In total, 52.2% of patients died; of the deaths, 33.0% were attributed to CAPA. We found that the cumulative incidence of CAPA in the ICU ranged from 1.0% to 39.1%.

COVID-19-associated pulmonary aspergillosis, March-August 2020

Bartoletti M.;
2021-01-01

Abstract

Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data from 186 patients who had coronavirus disease-associated pulmonary aspergillosis (CAPA) worldwide during March-August 2020. Overall, 182 patients were admitted to the intensive care unit (ICU), including 180 with acute respiratory distress syndrome and 175 who received mechanical ventilation. CAPA was diagnosed a median of 10 days after coronavirus disease diagnosis. Aspergillus fumigatus was identifi ed in 80.3% of patient cultures, 4 of which were azole-resistant. Most (52.7%) patients received voriconazole. In total, 52.2% of patients died; of the deaths, 33.0% were attributed to CAPA. We found that the cumulative incidence of CAPA in the ICU ranged from 1.0% to 39.1%.
2021
Aspergillus
COVID-19
SARS-CoV-2
aspergillosis
coronavirus disease
coronaviruses
fungi
intensive care unit
respiratory infections
severe acute respiratory syndrome coronavirus 2
viruses
voriconazole
zoonoses
Aged
Antifungal Agents
Aspergillus fumigatus
Female
Humans
Immunologic Factors
Incidence
Intensive Care Units
International Cooperation
Male
Outcome and Process Assessment
Health Care
Registries
Respiration
Artificial
Risk Factors
SARS-CoV-2
Voriconazole
COVID-19
Pulmonary Aspergillosis
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11699/74704
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