COVID-19-associated pulmonary aspergillosis: an underdiagnosed or overtreated infection?

Document type :

Article dans une revue scientifique

DOI :

10.1097/mcc.0000000000000977

Permalink :

http://hdl.handle.net/20.500.12210/111767

Title :

COVID-19-associated pulmonary aspergillosis: an underdiagnosed or overtreated infection?

Author(s) :

Rouze, Anahita [Auteur]

Martin-Loeches, Ignacio [Auteur]
Nseir, Saad [Auteur]

Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576

Journal title :

Current Opinion in Critical Care

Volume number :

28

Pages :

470-479

Publisher :

Ovid Technologies (Wolters Kluwer Health)

Publication date :

2022-08-11

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Purpose of review Coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA) may concern up to one third of intensive care unit (ICU) patients. The purpose of this review is to discuss the ...
Show more >Purpose of review Coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA) may concern up to one third of intensive care unit (ICU) patients. The purpose of this review is to discuss the diagnostic criteria, the pathogenesis, the risk factors, the incidence, the impact on outcome, and the diagnostic and therapeutic management of CAPA in critically ill patients. Recent findings The incidence of CAPA ranges 3--28% of critically ill patients, depending on the definition used, study design, and systematic or triggered screening. COVID-19 is associated with direct damage of the respiratory epithelium, immune dysregulation, and common use of immunosuppressive drugs which might promote Aspergillus respiratory tract colonization and invasion. Positive Aspergillus tests among COVID-19 critically patients might reflect colonization rather than invasive disease. CAPA usually appears during the second week after starting invasive mechanical ventilation and is independently associated with ICU mortality. Summary Further studies are needed to validate CAPA case definitions, to determine the accurate incidence of CAPA in comparison to adequate controls, and its evolution during the pandemic. A pro-active diagnostic strategy, based on risk stratification, clinical assessment, and bronchoalveolar lavage could be recommended to provide early antifungal treatment in patients with high probability of CAPA and clinical deterioration.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CNRS

Collections :

Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576

Research team(s) :

Glycobiology in fungal Pathogenesis and Clinical Applications

Submission date :

2024-03-25T15:49:26Z

Files

P22.63 Rouze A 2022 Curr Opin Crit Care. 2022;28(5) 470-9.pdf
Version éditeur
Open access
Access the document

Version history