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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Ghazanfari, M; Arastehfar, A; Davoodi, L; Yazdani, Charati, J; Moazeni, M; Abastabar, M; Haghani, I; Mirzakhani, R; Mayahi, S; Fang, W; Liao, W; Nguyen, MH; Perlin, DS; Hoenigl, M; Pan, W; Hedayati, MT.
Pervasive but Neglected: A Perspective on COVID-19-Associated Pulmonary Mold Infections Among Mechanically Ventilated COVID-19 Patients.
Front Med (Lausanne). 2021; 8: 649675 Doi: 10.3389/fmed.2021.649675 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz: Hönigl Martin
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Abstract:: Background: Recent studies from multiple countries have shown a high prevalence of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) among severely ill patients. Despite providing valuable insight into the clinical management of CAPA, large-scale prospective studies are limited. Here, we report on one of the largest multicenter epidemiological studies to explore the clinical features and prevalence of COVID-19-associated pulmonary mold infections (CAPMIs) among mechanically ventilated patients. Methods: Bronchoalveolar lavage (BAL) and serum samples were collected for culture, galactomannan (GM), and β-D-glucan (BDG) testing. Patients were classified as probable CAPMI based on the presence of host factors, radiological findings, and mycological criteria. Results: During the study period, 302 COVID-19 patients were admitted to intensive care units (ICUs), among whom 105 were mechanically ventilated for ≥4 days. Probable CAPMI was observed among 38% of patients (40/105), among whom BAL culture of 29 patients turned positive for molds, while galactomannan testing on BAL (GM index ≥1) and serum (GM index >0.5) samples were positive for 60% (24/40) and 37.5% (15/39) of patients, respectively. Aspergillus (22/29; 75.8%) and Fusarium (6/29; 20.6%) constituted 96.5% of the molds isolated. Diaporthe foeniculina was isolated from a COVID-19 patient. None of the patients who presented with CAPMI were treated with antifungal drugs. Conclusion: Despite being prevalent, the absence of appropriate antifungal treatment highlights that CAPMI is a neglected complication among mechanically ventilated COVID-19 patients admitted to ICUs. CAPMI can be caused by species other than Aspergillus.
Find related publications in this database (Keywords): COVID-19-associated pulmonary mold infections; mechanically ventilation; galactomannan; Aspergillus; Fusarium