Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: Results from the prospective AspCOVID-19 study.

Lahmer, Tobias; Kriescher, Silja; Herner, Alexander; Rothe, Kathrin; Spinner, Christoph D; Schneider, Jochen; Mayer, Ulrich; Neuenhahn, Michael; Hoffmann, Dieter; Geisler, Fabian; Heim, Markus; Schneider, Gerhard; Schmid, Roland M; Huber, Wolfgang; Rasch, Sebastian

doi:10.1371/journal.pone.0238825

Benutzer: Gast

2021

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Titel:: Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: Results from the prospective AspCOVID-19 study.
Dokumenttyp:: Journal Article
Autor(en):: Lahmer, Tobias; Kriescher, Silja; Herner, Alexander; Rothe, Kathrin; Spinner, Christoph D; Schneider, Jochen; Mayer, Ulrich; Neuenhahn, Michael; Hoffmann, Dieter; Geisler, Fabian; Heim, Markus; Schneider, Gerhard; Schmid, Roland M; Huber, Wolfgang; Rasch, Sebastian
Abstract:: BACKGROUND: Superinfections, 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. METHODS: We 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 nondirected bronchial lavage (NBL). We used logistic regression analyses to assess if COVID-19 was independently associated with IPA and compared it with matched controls. FINDINGS: CAPA 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. INTERPRETATION: CAPA 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.
Zeitschriftentitel:: PLoS ONE
Jahr:: 2021
Band / Volume:: 16
Heft / Issue:: 3
Volltext / DOI:: doi:10.1371/journal.pone.0238825
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/33730058
Print-ISSN:: 1932-6203
TUM Einrichtung:: II. Medizinische Klinik und Poliklinik (Gastroenterologie); Institut für Medizinische Mikrobiologie, Immunologie und Hygiene; Klinik für Anästhesiologie (DHM)
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