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COVID-19-Associated Invasive Pulmonary Aspergillosis in the Intensive Care Unit: A Case Series in a Portuguese Hospital

2021-10-19Journal article Open access
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dc.contributor.authorRanhel, David
dc.contributor.authorRibeiro, Ana
dc.contributor.authorBatista, Judite
dc.contributor.authorPessanha, Maria
dc.contributor.authorCristovam, Elisabete
dc.contributor.authorDuarte, Ana
dc.contributor.authorDias, Ana
dc.contributor.authorCoelho, Luís
dc.contributor.authorMonteiro, Filipa
dc.contributor.authorFreire, Pedro
dc.contributor.authorVeríssimo, Cristina
dc.contributor.authorSabino, Raquel
dc.contributor.authorToscano, Cristina
dc.date.accessioned2022-03-10T16:43:20Z
dc.date.available2022-03-10T16:43:20Z
dc.date.issued2021-10-19
dc.description.abstractInvasive pulmonary aspergillosis (IPA) has become a recognizable complication in coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Alveolar damage in the context of acute respiratory distress syndrome (ARDS) appears to be the culprit in facilitating fungal invasion in COVID-19 patients, leading to a COVID-19-associated pulmonary aspergillosis (CAPA) phenomenon. From November 2020 to 15 February 2021, 248 COVID-19 patients were admitted to our ICUs, of whom ten patients (4% incidence) were classified as either probable (six) or possible (four) CAPA cases. Seven patients had positive cultural results: Aspergillus fumigatus sensu stricto (five), A. terreus sensu stricto (one), and A. welwitschiae (one). Five patients had positive bronchoalveolar lavage (BAL) and galactomannan (GM), and two patients had both positive cultural and GM criteria. All but two patients received voriconazole. Mortality rate was 30%. Strict interpretation of classic IPA definition would have resulted in eight overlooked CAPA cases. Broader diagnostic criteria are essential in this context, even though differentiation between Aspergillus colonization and invasive disease might be more challenging. Herein, we aim to raise awareness of CAPA in view of its potential detrimental outcome, emphasizing the relevance of a low threshold for screening and early antifungal treatment in ARDS patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Fungi (Basel). 2021 Oct 19;7(10):881. doi: 10.3390/jof7100881.pt_PT
dc.identifier.doi10.3390/jof7100881pt_PT
dc.identifier.issn2309-608X
dc.identifier.urihttp://hdl.handle.net/10400.18/7984
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.relation.publisherversionhttps://www.mdpi.com/2309-608X/7/10/881pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectCOVID-19pt_PT
dc.subjectIntensive Care Unitpt_PT
dc.subjectAspergilluspt_PT
dc.subjectInvasive Pulmonary Aspergillosispt_PT
dc.subjectCOVID-19-Associated Invasive Pulmonary Aspergillosispt_PT
dc.subjectCAPApt_PT
dc.subjectInfecções Respiratóriaspt_PT
dc.subjectPortugalpt_PT
dc.titleCOVID-19-Associated Invasive Pulmonary Aspergillosis in the Intensive Care Unit: A Case Series in a Portuguese Hospitalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue10pt_PT
oaire.citation.startPage881pt_PT
oaire.citation.titleJournal of Fungipt_PT
oaire.citation.volume7pt_PT
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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