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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Pulmonary aspergillosis in critically ill patients with Coronavirus Disease 2019 (COVID-19)

Damien Dupont1,2, Jean Menotti1,3, Jean Turc4

  • 1Institut des Agents Infectieux, Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, F-69004, France.

Medical Mycology
|September 11, 2020
PubMed

Insights

Pulmonary aspergillosis is a significant risk for intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19). Early detection and antifungal treatment are crucial for managing this opportunistic infection in critically ill patients.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • The emergence of coronavirus disease 2019 (COVID-19) presented new challenges in intensive care units (ICUs).
  • Invasive pulmonary aspergillosis is a serious fungal infection that can affect critically ill patients.
  • The interaction between COVID-19 and invasive pulmonary aspergillosis requires further investigation.

Purpose of the Study:

  • To determine the occurrence of putative invasive pulmonary aspergillosis in adult ICU patients during the COVID-19 pandemic.
  • To assess the prevalence of Aspergillus infection in COVID-19 patients admitted to the ICU.
  • To highlight the need for active surveillance and prompt treatment of invasive pulmonary aspergillosis in this population.

Main Methods:

  • Screening of 153 consecutive adult ICU patients over a 6-week period.
  • Analysis of respiratory samples for mycological diagnosis.
  • Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using polymerase chain reaction (PCR).

Main Results:

  • 106 patients (69.3%) tested positive for SARS-CoV-2.
  • Nineteen patients (17.9%) with positive Aspergillus results were diagnosed with putative invasive pulmonary aspergillosis.
  • A significant proportion of COVID-19 ICU patients were found to have Aspergillus infections.

Conclusions:

  • COVID-19 patients in the ICU are at high risk for developing invasive pulmonary aspergillosis.
  • Active surveillance for Aspergillus infection is recommended in critically ill COVID-19 patients, even those not previously known to be immunosuppressed.
  • Standardized protocols and updated definitions are needed for diagnosing and managing ICU putative invasive pulmonary aspergillosis.
Keywords:
AspergillusCOVID-19COVID-19 associated pulmonary aspergillosis (CAPA)acute respiratory distress syndromeintensive care unitpulmonary aspergillosis

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