Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: results from the prospective AspCOVID-19 study
Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: results from the prospective AspCOVID-19 study
Summary BackgroundSuperinfections, 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. MethodsWe 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. FindingsCAPA 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. InterpretationCAPA 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. FundingNone
Rasch Sebastian、Lahmer Tobias、Kriescher Silja、Schneider Jochen、Neuenhahn Michael、Geisler Fabian、Huber Wolfgang、Schneider Gerhard、Mayer Ulrich、Schmid Roland M、Herner Alexander、Heim Markus、Spinner Christoph D.、Hoffmann Dieter、Rothe Kathrin
Klinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Aneasthesiologie und Intensivmedizin, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenInstitut f¨1r Mikrobiologie, Immunologie und Hygiene, Technische Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Aneasthesiologie und Intensivmedizin, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Aneasthesiologie und Intensivmedizin, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenKlinik und Poliklinik f¨1r Innere Medizin II, Klinikum rechts der Isar der Technischen Universit?t M¨1nchenInstitut f¨1r Virologie, Technische Universit?t M¨1nchenInstitut f¨1r Mikrobiologie, Immunologie und Hygiene, Technische Universit?t M¨1nchen
医学研究方法内科学临床医学
COVID-19SARS-CoV-2invasive pulmonary aspergillosiscritically illgalactomannanARDS
Rasch Sebastian,Lahmer Tobias,Kriescher Silja,Schneider Jochen,Neuenhahn Michael,Geisler Fabian,Huber Wolfgang,Schneider Gerhard,Mayer Ulrich,Schmid Roland M,Herner Alexander,Heim Markus,Spinner Christoph D.,Hoffmann Dieter,Rothe Kathrin.Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: results from the prospective AspCOVID-19 study[EB/OL].(2025-03-28)[2025-04-30].https://www.medrxiv.org/content/10.1101/2020.07.21.20158972.点此复制
评论