Invasive Aspergillosis associated with Covid-19: A word of caution
Laura Gouzien1, Theophile Cocherie2, Odile Eloy2
1Intensive Care Unit, Centre Hospitalier de Versailles-Site André Mignot, 177, rue de Versailles, 78150 Le Chesnay cedex, France.
Introduction:
Invasive pulmonary aspergillosis is a well-known complication of acute respiratory distress syndrome, the most serious manifestation of COVID-19. Four recent studies have reported its incidence among ICU COVID-19 patients. However, they do not share the same case definition, and have provided conflicting results. In this paper we have aimed at reported the incidence of invasive pulmonary aspergillosis for COVID-19 patients in our ICU, and at comparing the different definitions in order to assess their respective relevance.
Methods:
Retrospective cohort study of critically ill patients with severe COVID-19 requiring ICU management between 1st March and 30th April 2020.
Results:
Our results showed significantly lower incidence of invasive pulmonary aspergillosis (1.8%;1/53), compared to three out of four previous studies, and wide variation in the numbers of cases with regard to the different definitions.
Conclusion:
Large-scale studies are needed for a better definition and a more accurate estimation of invasive pulmonary aspergillosis coinfection during COVID-19.
Insights
Invasive pulmonary aspergillosis occurred in 1.8% of severe COVID-19 patients. Definitions for this fungal coinfection varied, impacting incidence rates in intensive care unit settings.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- Invasive pulmonary aspergillosis (IPA) is a severe complication of acute respiratory distress syndrome (ARDS) in COVID-19 patients.
- Previous studies reported varying IPA incidence in ICU COVID-19 patients due to differing case definitions.
- Accurate incidence and definition relevance require further investigation.
Purpose of the Study:
- To determine the incidence of IPA in severe COVID-19 patients admitted to the ICU.
- To compare the relevance of different IPA case definitions in this population.
Main Methods:
- Retrospective cohort study design.
- Inclusion of critically ill COVID-19 patients requiring ICU management.
- Data collected between March 1st and April 30th, 2020.
Main Results:
- The incidence of IPA was found to be 1.8% (1/53 patients).
- This incidence was significantly lower than reported in three of four prior studies.
- Significant variation in case numbers was observed across different diagnostic definitions.
Conclusions:
- Large-scale studies are essential for refining IPA case definitions.
- More accurate estimation of IPA coinfection prevalence in COVID-19 is needed.
- Standardized definitions are crucial for reliable incidence reporting.
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