Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

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

    Authors: Tobias Lahmer

    doi:10.1101/2020.07.21.20158972 Date: 2020-07-22 Source: medRxiv

    Background: Superinfections MESHD, including invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP (IPA), are well-known complications of critically ill patients with severe viral pneumonia MESHD pneumonia HP. Aim of this study was to evaluate the incidence, risk factors and outcome of IPA in critically ill patients with severe COVID-19 pneumonia MESHD pneumonia HP. Methods: We prospectively screened 32 critically ill patients with severe COVID-19 pneumonia MESHD pneumonia HP for a time period of 28 days using a standardized study protocol for oberservation of developement of COVID-19 associated invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP (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 MESHD pneumonia HP as compared to 8% in the control cohort. In the COVID-19 cohort, mean age TRANS, 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 MESHD invasive pulmonary aspergillosis HP. A standardized screening and diagnostic approach as presented in our study can help to identify affected patients at an early stage.

    High prevalence SERO of putative invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP in critically ill COVID-19 patients

    Authors: Alexandre Alanio; Sarah Delliere; Sofiane Fodil; Stephane Bretagne; Bruno Megarbane

    doi:10.1101/2020.04.21.20064915 Date: 2020-04-24 Source: medRxiv

    We are currently facing a frightening increase in COVID-19 patients admitted to the ICU. Aiming at screening for fungal secondary pneumonia MESHD pneumonia HP, 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 MESHD in influenza patients in your journal (Schauwvlinghe et al., 2018.) and found 33% of our COVID-19 patients with putative invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP. Observing such a high prevalence SERO in COVID-infected patients was somehow unexpected since the 30% prevalence SERO of invasive aspergillosis MESHD 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 MESHD, antifungal prophylactic therapy may be questioned to avoid increased lung inflammation MESHD 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. This message is major, given the high mortality rate of COVID-19 patients in the ICU.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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