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Invasive pulmonary aspergillosis in COVID-19 critically ill patients: Results of a French monocentric cohort - 29/05/21

Doi : 10.1016/j.mycmed.2021.101122 
Maaike Versyck, Wafa Zarrougui, Fabien Lambiotte, Nabil Elbeki, Piehr Saint-Leger
 Department of Anesthesiology and Intensive Care Medicine, General Hospital of Valenciennes, France 

Corresponding author.

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Abstract

Introduction

Coronavirus disease 2019 or COVID-19 is a new infectious disease responsible for potentially severe respiratory impairment associated with initial immunosuppression. Similarly to influenza, several authors have described a higher risk of fungal infection after COVID-19, in particular for invasive pulmonary aspergillosis. The main objective here is to define the prevalence of invasive pulmonary aspergillosis (IPA) in a cohort of COVID-19 patients with moderate to severe acute respiratory disease syndrome (ARDS).

Material and methods

We conducted a large monocentric retrospective study investigating all the ventilated COVID-19 patients with ARDS hospitalized at Valenciennes’ general hospital, France, between March 15, 2020 and April 30, 2020. In the center a systematic IPA screening strategy was carried out for all ARDS patients, with weekly tests of serum galactomannan and beta-D-glucan. Bronchoalveolar lavage with culture and chest CT scan were performed when the serum assays were positives.

Results

A total of 54 patients were studied. Their median age was 65 years, and 37 of the patients (71%) were male. Two patients had chronic immunosuppression and among all the patients, only 2 non-immunocompromised presented a putative IPA during their stay.

Conclusion

The prevalence of IPA in this cohort of COVID-19 patients (3.7%) is not higher than what is described in the other ARDS populations in the literature. These results are however different from the previous publications on COVID-19 patients and must therefore be confirmed by larger and multicentric studies.

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Keywords : COVID-19, Invasive pulmonary aspergillosis, Intensive care unit, SARS-CoV-2

Abbreviations : ARDS, BAL, BDG, BMI, EORTC, GM, ICU, IFI, IPA, SD, TA


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Vol 31 - N° 2

Artículo 101122- juin 2021 Regresar al número
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