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Does Pulmonary Aspergillosis Complicate Coronavirus Disease 2019?
Karlyn D Beer1, Brendan R Jackson1, Tom Chiller1
1Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA.
Critical Care Explorations
|September 28, 2020
Summary
Aspergillus coinfection in coronavirus disease 2019 patients is emerging as a critical concern. Early suspicion and testing for Aspergillus in severe COVID-19 cases are vital for understanding and preventing mortality.
Area of Science:
- Critical care medicine
- Infectious diseases
- Pulmonology
Background:
- Aspergillus coinfection is rarely reported in coronavirus disease 2019 (COVID-19) patients.
- Previous fungal coinfections in viral illnesses, like influenza-associated pulmonary aspergillosis, suggest COVID-19-associated aspergillosis is plausible.
- COVID-19 patients in intensive care units (ICUs) may be at risk for Aspergillus coinfection.
Purpose of the Study:
- To summarize current knowledge on COVID-19 complicated by Aspergillus.
- To introduce COVID-19-associated pulmonary aspergillosis as a potential clinical entity.
- To outline reasons for suspecting Aspergillus in critically ill COVID-19 patients.
Main Methods:
- Systematic review of published COVID-19 patient case series.
- Inclusion of case descriptions and review of potential biologic mechanisms.
- Selection of reports with clinical, microbiologic, or radiologic signs of invasive fungal infection.
Main Results:
- Descriptive data from available COVID-19-associated pulmonary aspergillosis case series were analyzed.
- Evidence suggests Aspergillus coinfection occurs in severe COVID-19 patients.
Conclusions:
- Pulmonary aspergillosis in critically ill influenza patients is linked to higher mortality.
- Early clinical suspicion and diagnostic testing for Aspergillus in COVID-19 patients are crucial.
- Further reports and registry contributions are needed to understand the epidemiology and impact of Aspergillus coinfection in COVID-19.
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