1887

Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) are at risk of invasive pulmonary aspergillosis. The clinical manifestations of a superimposed fungal infection in those patients are difficult to underpin. This is compounded by the non-specific radiological findings associated with this infection and the challenges associated with performing bronchoscopy in COVID-19 patients. We would like to present two COVID-19 cases who developed secondary pulmonary infection in the intensive care unit as shown by respiratory cultures, serum galactomannan and radiological images. Despite advanced intensive care and use of antifungal agents, both patients died eventually. This report illustrates the negative impact of secondary Aspergillosis and calls for the need of increased awareness of COVID19-associated pulmonary aspergillosis.

Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000201
2021-02-11
2021-02-26
Loading full text...

Full text loading...

/deliver/fulltext/acmi/10.1099/acmi.0.000201/acmi000201.html?itemId=/content/journal/acmi/10.1099/acmi.0.000201&mimeType=html&fmt=ahah

References

  1. Cevik M, Bamford CGG, Ho A. COVID-19 pandemic-a focused review for clinicians. Clin Microbiol Infect 2020; 26: 842 847 [CrossRef] [PubMed]
    [Google Scholar]
  2. Rutsaert L, Steinfort N, Van Hunsel T, Bomans P, Naesens R et al. COVID-19-associated invasive pulmonary aspergillosis. Ann Intensive Care 2020; Jun 1;10: 71
    [Google Scholar]
  3. Armstrong-James D, Youngs J, Bicanic T, Abdolrasouli A, Denning DW. Confronting and mitigating the risk of COVID-19 associated pulmonary aspergillosis (CapA). Eur Respir J 2020; 2002554:
    [Google Scholar]
  4. The ARDS Definition Task Force Acute respiratory distress syndrome: the Berlin definition. JAMA 2012; 307: 2526 2533
    [Google Scholar]
  5. COVID 19 Updates [Internet]. Ministry of health. State of Kuwait. [ live; cited 2020 Dec 11] Available from: https://corona.e.gov.kw/en .
  6. Mohamed A, Rogers TR, Talento AF. COVID-19 associated invasive pulmonary aspergillosis: diagnostic and therapeutic challenges. J Fungi 2020; 6: E115 115 [CrossRef] [PubMed]
    [Google Scholar]
  7. Nasir N, Farooqi J, Mahmood SF, Jabeen K. COVID‐19‐associated pulmonary aspergillosis (CapA) in patients admitted with severe COVID‐19 pneumonia: an observational study from Pakistan. Mycoses 2020; 63: 766 770 [CrossRef]
    [Google Scholar]
  8. Lamoth F, Glampedakis E, Boillat-Blanco N, Oddo M, Pagani J-L. Incidence of invasive pulmonary aspergillosis among critically ill COVID-19 patients. Clin Microbiol Infect 2020; S1198-743X: 30412 2
    [Google Scholar]
  9. Verweij PE, Rijnders BJA, Brüggemann RJM, Azoulay E, Bassetti M et al. Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion. Intensive Care Med 2020; 46: 1524 1535 [CrossRef]
    [Google Scholar]
  10. Bartoletti M, Pascale R, Cricca M et al. Epidemiology of invasive pulmonary aspergillosis among COVID-19 intubated patients: a prospective study. Clin Infect Dis 2020 ciaa1065
    [Google Scholar]
  11. Schauwvlieghe AFAD, Rijnders BJA, Philips N, Verwijs R, Vanderbeke L et al. Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study. The Lancet Respir Med 2018; 6: 782 792 [CrossRef]
    [Google Scholar]
  12. Verweij PE, Gangneux J-P, Bassetti M, Brüggemann RJM, Cornely OA et al. Diagnosing COVID-19-associated pulmonary aspergillosis. The Lancet Microbe 2020; 1: e53 e55 [CrossRef]
    [Google Scholar]
  13. Blot S, Rello J, Koulenti D. Diagnosing invasive pulmonary aspergillosis in ICU patients: putting the puzzle together. Curr Opin Crit Care 2019; 25: 430 437
    [Google Scholar]
  14. Recovery: Randomised Evaluation of Covid-19 Therapy 2020 [cited 2020 17th June]. Available from: https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf .
  15. Tortorano AM, Dho G, Prigitano A, Breda G, Grancini A et al. Invasive fungal infections in the intensive care unit: a multicentre, prospective, observational study in Italy (2006-2008). Mycoses 2012; 55: 73 79 [CrossRef]
    [Google Scholar]
  16. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. The Lancet 2009; 374: 1351 1363 [CrossRef]
    [Google Scholar]
  17. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS et al. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet 2020; 395: 1033 1034 [CrossRef]
    [Google Scholar]
  18. Brüggemann RJ, van de Veerdonk FL, Verweij PE. The challenge of managing COVID-19 associated pulmonary aspergillosis [published online ahead of print, 2020 Aug 18]. Clin Infect Dis 2020 ciaa1211
    [Google Scholar]
  19. Ullmann AJ, Aguado JM, Arikan-Akdagli S, Denning DW, Groll AH et al. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect 2018 e1–e38
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000201
Loading
/content/journal/acmi/10.1099/acmi.0.000201
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error