Your browser doesn't support javascript.
Invasive mould disease in fatal COVID-19: a systematic review of autopsies.
Kula, Brittany E; Clancy, Cornelius J; Hong Nguyen, M; Schwartz, Ilan S.
  • Kula BE; Department of Medicine, Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Clancy CJ; Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
  • Hong Nguyen M; Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
  • Schwartz IS; Department of Medicine, Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Lancet Microbe ; 2(8): e405-e414, 2021 08.
Article in English | MEDLINE | ID: covidwho-1286408
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
ABSTRACT
Invasive mould disease (IMD) might affect up to a third of critically ill patients with COVID-19. COVID-19-associated pulmonary aspergillosis (CAPA) is typically diagnosed on the basis of a combination of non-specific clinical, radiographical, and mycological findings, but whether most cases represent invasive disease is unresolved. We systematically reviewed autopsy series of three or more decedents with COVID-19 for evidence of IMD. We searched PubMed, Web of Science, OVID (Embase), and medRxiv for studies in English or French published from Jan 1, 2019, to Sept 26, 2020. We identified 1070 references, of which 50 studies met the criteria. These studies described autopsies from 677 decedents, with individual-level data for 443 decedents. The median age was 70·0 years (IQR 57·0-79·0). Of decedents with individual-level data, 133 (30%) had diabetes, 97 (22%) had pre-existing lung disease, and 27 (6%) had immunocompromising conditions. Of 548 decedents with such data, 320 (58%) received invasive mechanical ventilation; among 140 decedents for whom this was known, ventilation was for a median of 9·0 days (IQR 5·0-20·0). Treatment included immunomodulation in 60 decedents and antifungals in 50 decedents. Autopsy-proven IMD occurred in 11 (2%) of 677 decedents, including eight CAPA, two unspecified IMD, and one disseminated mucormycosis. Among 320 decedents who received mechanical ventilation, six (2%) had IMD. We conclude that IMD, including CAPA, is an uncommon autopsy finding in COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Aspergillosis / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Aged / Humans Language: English Journal: Lancet Microbe Year: 2021 Document Type: Article Affiliation country: S2666-5247(21)00091-4

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Aspergillosis / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Aged / Humans Language: English Journal: Lancet Microbe Year: 2021 Document Type: Article Affiliation country: S2666-5247(21)00091-4