Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory...

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Autores principales:	Emilien Gregoire, Benoit François Pirotte, Filip Moerman, Antoine Altdorfer, Laura Gaspard, Eric Firre, Martial Moonen, Vincent Fraipont, Marie Ernst, Gilles Darcis
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	coronavirus disease 2019 (COVID-19) invasive pulmonary aspergillosis (IPA) COVID-19-associated pulmonary aspergillosis (CAPA) intensive care unit (ICU) bronchoalveolar lavage (BAL) galactomannan (GM) Medicine R
Acceso en línea:	https://doaj.org/article/dba204903184475b9b9803c8b13f8fa6
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spelling	oai:doaj.org-article:dba204903184475b9b9803c8b13f8fa62021-11-25T18:37:42ZIncidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study10.3390/pathogens101113702076-0817https://doaj.org/article/dba204903184475b9b9803c8b13f8fa62021-10-01T00:00:00Zhttps://www.mdpi.com/2076-0817/10/11/1370https://doaj.org/toc/2076-0817Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory insufficiency due to COVID-19 from March to December 2020, in order to evaluate the incidence of CAPA and the associated risk factors. We also analysed the diagnostic approach used in our medical centre for CAPA diagnosis. We defined CAPA using recently proposed consensus definitions based on clinical, radiological and microbiological criteria. Probable cases of CAPA occurred in 9 out of 141 patients included in the analysis (6.4%). All cases were diagnosed during the second wave of the pandemic. We observed a significantly higher realization rate of bronchoalveolar lavage (BAL) (51.1% vs. 28.6%, <i>p</i> = 0.01) and <i>Aspergillus</i> testing (through galactomannan, culture, PCR) on BAL samples during the second wave (<i>p</i> < 0.0001). The testing for <i>Aspergillus</i> in patients meeting the clinical and radiological criteria of CAPA increased between the two waves (<i>p</i> < 0.0001). In conclusion, we reported a low but likely underestimated incidence of CAPA in our population. A greater awareness and more systematic testing for <i>Aspergillus</i> are necessary to assess the real incidence and characteristics of CAPA.Emilien GregoireBenoit François PirotteFilip MoermanAntoine AltdorferLaura GaspardEric FirreMartial MoonenVincent FraipontMarie ErnstGilles DarcisMDPI AGarticlecoronavirus disease 2019 (COVID-19)invasive pulmonary aspergillosis (IPA)COVID-19-associated pulmonary aspergillosis (CAPA)intensive care unit (ICU)bronchoalveolar lavage (BAL)galactomannan (GM)MedicineRENPathogens, Vol 10, Iss 1370, p 1370 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronavirus disease 2019 (COVID-19) invasive pulmonary aspergillosis (IPA) COVID-19-associated pulmonary aspergillosis (CAPA) intensive care unit (ICU) bronchoalveolar lavage (BAL) galactomannan (GM) Medicine R
spellingShingle	coronavirus disease 2019 (COVID-19) invasive pulmonary aspergillosis (IPA) COVID-19-associated pulmonary aspergillosis (CAPA) intensive care unit (ICU) bronchoalveolar lavage (BAL) galactomannan (GM) Medicine R Emilien Gregoire Benoit François Pirotte Filip Moerman Antoine Altdorfer Laura Gaspard Eric Firre Martial Moonen Vincent Fraipont Marie Ernst Gilles Darcis Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
description	Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory insufficiency due to COVID-19 from March to December 2020, in order to evaluate the incidence of CAPA and the associated risk factors. We also analysed the diagnostic approach used in our medical centre for CAPA diagnosis. We defined CAPA using recently proposed consensus definitions based on clinical, radiological and microbiological criteria. Probable cases of CAPA occurred in 9 out of 141 patients included in the analysis (6.4%). All cases were diagnosed during the second wave of the pandemic. We observed a significantly higher realization rate of bronchoalveolar lavage (BAL) (51.1% vs. 28.6%, <i>p</i> = 0.01) and <i>Aspergillus</i> testing (through galactomannan, culture, PCR) on BAL samples during the second wave (<i>p</i> < 0.0001). The testing for <i>Aspergillus</i> in patients meeting the clinical and radiological criteria of CAPA increased between the two waves (<i>p</i> < 0.0001). In conclusion, we reported a low but likely underestimated incidence of CAPA in our population. A greater awareness and more systematic testing for <i>Aspergillus</i> are necessary to assess the real incidence and characteristics of CAPA.
format	article
author	Emilien Gregoire Benoit François Pirotte Filip Moerman Antoine Altdorfer Laura Gaspard Eric Firre Martial Moonen Vincent Fraipont Marie Ernst Gilles Darcis
author_facet	Emilien Gregoire Benoit François Pirotte Filip Moerman Antoine Altdorfer Laura Gaspard Eric Firre Martial Moonen Vincent Fraipont Marie Ernst Gilles Darcis
author_sort	Emilien Gregoire
title	Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
title_short	Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
title_full	Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
title_fullStr	Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
title_full_unstemmed	Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
title_sort	incidence and risk factors of covid-19-associated pulmonary aspergillosis in intensive care unit—a monocentric retrospective observational study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/dba204903184475b9b9803c8b13f8fa6
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Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study

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