دورية أكاديمية
أعرض في EDS

Regional Impact of COVID-19-Associated Pulmonary Aspergillosis (CAPA) during the First Wave.

التفاصيل البيبلوغرافية
العنوان: Regional Impact of COVID-19-Associated Pulmonary Aspergillosis (CAPA) during the First Wave.
المؤلفون: Bentvelsen RG; Microvida Laboratory for Microbiology, Amphia Hospital, 4818 CK Breda, The Netherlands.; Department of Medical Microbiology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands., Arkel ALEV; Microvida Laboratory for Microbiology, Amphia Hospital, 4818 CK Breda, The Netherlands.; Microvida Laboratory for Microbiology, ETZ, 5000 LE Tilburg, The Netherlands., Rijpstra TA; Department of Intensive Care Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands., Kant MKM; Department of Intensive Care Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands.; Department of Pulmonary Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands., Brugge SVS; Department of Pulmonary Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands., Loth DW; Department of Pulmonary Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands., Van Wijngaarden P; Department of Internal Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands., Mée AWFD; Department of Radiology, Amphia Hospital, 4818 CK Breda, The Netherlands., Yick DCY; Department of Pathology, Amphia Hospital, 4818 CK Breda, The Netherlands., Diederen BMW; Microvida Laboratory for Microbiology, Bravis Hospital, 4704 RA Roosendaal, The Netherlands., Wever PC; Department of Medical Microbiology, Bernhoven Hospital, 5406 PT Uden, The Netherlands., Leenders ACAP; Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 5223 GZ Hertogenbosch, The Netherlands., Van Dommelen L; Department of Medical Microbiology, Stichting PAMM, 5500 AA Veldhoven, The Netherlands., Groot KH; Department of Intensive Care, Máxima Medical Center, 5631 BM Veldhoven, The Netherlands., Van den Bijllaardt W; Microvida Laboratory for Microbiology, Amphia Hospital, 4818 CK Breda, The Netherlands., Verweij PE; Department of Medical Microbiology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.; Center of Expertise in Mycology Radboudumc/CWZ, 6252 AG Nijmegen, The Netherlands.
المصدر: Journal of fungi (Basel, Switzerland) [J Fungi (Basel)] 2022 Jan 19; Vol. 8 (2). Date of Electronic Publication: 2022 Jan 19.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101671827 Publication Model: Electronic Cited Medium: Internet ISSN: 2309-608X (Electronic) Linking ISSN: 2309608X NLM ISO Abbreviation: J Fungi (Basel) Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel, Switzerland : MDPI AG, [2015]-
مستخلص: Background: Critically ill COVID-19 patients have proven to be at risk for developing invasive fungal infections. However, the incidence and impact of possible/probable COVID-19-associated pulmonary aspergillosis (CAPA) in severe COVID-19 patients varies between cohorts. We aimed to assess the incidence, risk factors, and clinical outcome of invasive pulmonary aspergillosis in a regional cohort of COVID-19 intensive care patients.
Methods: We performed a regional, multicentre, retrospective cohort study in the intensive care units (ICUs) in North Brabant, The Netherlands. We included adult patients with rt-PCR-confirmed SARS-CoV-2 infection (COVID-19), requiring mechanical ventilation for acute respiratory distress syndrome. Demographics, clinical course, biomarker value, and treatment outcomes were compared between the groups with possible/probable CAPA from the main study centre and the regional centres, and without signs of CAPA from the main study centre as controls. The primary aim was to assess the regional impact of possible/probable CAPA in COVID-19 ICU patients, measured as all-cause mortality at 30 days after ICU admission. Secondary outcomes were risk factors for developing CAPA, based on underlying host factors and to identify the value of the mycological arguments for the diagnosing of CAPA.
Results: Between 1 March and 30 April 2020, we included 123 patients with severe COVID-19: 29 patients (30.9%) in the main ICU with possible/probable CAPA, and 65 (69.1%) with no signs of CAPA; 29 patients in the regional ICUs with signs of CAPA. Patients' characteristics and risk factors did not differ for CAPA and non-CAPA patients. Patients with COPD and/or chronic steroid medication developed CAPA more frequently, although this was not statistically significant. CAPA patients were admitted to the ICU earlier, had lower PF-ratios, and more often required renal replacement therapy. All-cause 30-day mortality was significantly higher in mechanically ventilated COVID-19 patients with possible/probable CAPA 39.7% (23/58) compared to patients without evidence for CAPA 16.9% (11/65) (OR 3.2 [95% CI 1.4-7.4] p = 0.005).
Conclusion: The high incidence of possible and probable CAPA in critically ill COVID-19 patients is alarming. The increase in 30-day mortality in CAPA highlights the need for active surveillance and management strategies in critically ill COVID-19 patients.
References: Intensive Care Med. 2021 Aug;47(8):819-834. (PMID: 34160631)
Lancet Respir Med. 2020 Jun;8(6):e48-e49. (PMID: 32445626)
Lancet Infect Dis. 2021 Jun;21(6):e149-e162. (PMID: 33333012)
Ned Tijdschr Geneeskd. 2020 Apr 2;164:. (PMID: 32391998)
Mycoses. 2020 Jun;63(6):528-534. (PMID: 32339350)
Clin Infect Dis. 2021 Oct 5;73(7):e1634-e1644. (PMID: 32860682)
J Mycol Med. 2020 Jun;30(2):100971. (PMID: 32307254)
Lancet Respir Med. 2022 Feb;10(2):180-190. (PMID: 34843666)
Ann Intensive Care. 2020 Jun 1;10(1):71. (PMID: 32488446)
Lancet Microbe. 2020 Jun;1(2):e53-e55. (PMID: 32835328)
Intensive Care Med. 2021 Nov 29;:. (PMID: 34842962)
Clin Infect Dis. 2021 Dec 6;73(11):e3606-e3614. (PMID: 32719848)
Lancet. 2020 Mar 28;395(10229):1054-1062. (PMID: 32171076)
Am J Respir Crit Care Med. 2020 Jul 1;202(1):132-135. (PMID: 32396381)
فهرسة مساهمة: Keywords: CAPA; COVID-19; corticosteroids; pulmonary aspergillosis; voriconazole
تواريخ الأحداث: Date Created: 20220225 Latest Revision: 20220301
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8875881
DOI: 10.3390/jof8020096
PMID: 35205851
قاعدة البيانات: MEDLINE
الوصف
تدمد:2309-608X
DOI:10.3390/jof8020096