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SHR Neuro Cancer Cardio Lipid Metab Microb

Feys, S; Carvalho, A; Clancy, CJ; Gangneux, JP; Hoenigl, M; Lagrou, K; Rijnders, BJA; Seldeslachts, L; Vanderbeke, L; van, de, Veerdonk, FL; Verweij, PE; Wauters, J.
Influenza-associated and COVID-19-associated pulmonary aspergillosis in critically ill patients.
Lancet Respir Med. 2024; 12(9):728-742 Doi: 10.1016/S2213-2600(24)00151-6
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Co-authors Med Uni Graz

Hönigl Martin

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Abstract:

Influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) are increasingly recognised as important complications in patients requiring intensive care for severe viral pneumonia. The diagnosis can typically be made in 10-20% of patients with severe influenza or COVID-19, but only when appropriate diagnostic tools are used. Bronchoalveolar lavage sampling for culture, galactomannan testing, and PCR forms the cornerstone of diagnosis, whereas visual examination of the tracheobronchial tract during bronchoscopy is required to detect invasive Aspergillus tracheobronchitis. Azoles are the first-choice antifungal drugs, with liposomal amphotericin B as an alternative in settings where azole resistance is prevalent. Despite antifungal therapy, IAPA and CAPA are associated with poor outcomes, with fatality rates often exceeding 50%. In this Review, we discuss the mechanistic and clinical aspects of IAPA and CAPA. Moreover, we identify crucial knowledge gaps and formulate directions for future research.

Find related publications in this database (using NLM MeSH Indexing)

Humans - administration & dosage

COVID-19 - complications

Critical Illness - administration & dosage

Influenza, Human - complications

Antifungal Agents - therapeutic use

SARS-CoV-2 - administration & dosage

Pulmonary Aspergillosis - complications, drug therapy, diagnosis

Find related publications in this database (Keywords)

unit (ICU) admissions for respiratory failure

particularly

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