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Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study.
Rouzé, Anahita; Lemaitre, Elise; Martin-Loeches, Ignacio; Povoa, Pedro; Diaz, Emili; Nyga, Rémy; Torres, Antoni; Metzelard, Matthieu; Du Cheyron, Damien; Lambiotte, Fabien; Tamion, Fabienne; Labruyere, Marie; Boulle Geronimi, Claire; Luyt, Charles-Edouard; Nyunga, Martine; Pouly, Olivier; Thille, Arnaud W; Megarbane, Bruno; Saade, Anastasia; Magira, Eleni; Llitjos, Jean-François; Ioannidou, Iliana; Pierre, Alexandre; Reignier, Jean; Garot, Denis; Kreitmann, Louis; Baudel, Jean-Luc; Voiriot, Guillaume; Plantefeve, Gaëtan; Morawiec, Elise; Asfar, Pierre; Boyer, Alexandre; Mekontso-Dessap, Armand; Makris, Demosthenes; Vinsonneau, Christophe; Floch, Pierre-Edouard; Marois, Clémence; Ceccato, Adrian; Artigas, Antonio; Gaudet, Alexandre; Nora, David; Cornu, Marjorie; Duhamel, Alain; Labreuche, Julien; Nseir, Saad.
  • Rouzé A; CHU de Lille, Médecine Intensive-Réanimation, 59000, Lille, France.
  • Lemaitre E; INSERM U1285, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Université de Lille, 59000, Lille, France.
  • Martin-Loeches I; CHU de Lille, Médecine Intensive-Réanimation, 59000, Lille, France.
  • Povoa P; Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland.
  • Diaz E; Department of Clinical medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland.
  • Nyga R; Hospital Clinic, IDIBAPS, Universidad de Barcelona, Ciberes, Barcelona, Spain.
  • Torres A; Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal.
  • Metzelard M; NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
  • Du Cheyron D; Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark.
  • Lambiotte F; Critical Care Department, Hospital Universitari Parc Tauli, Sabadell, Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, Spain.
  • Tamion F; Service de médecine intensive réanimation, CHU Amiens Picardie, 80000, Amiens, France.
  • Labruyere M; Department of Pulmonology, Hospital Clinic of Barcelona, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
  • Boulle Geronimi C; Service de médecine intensive réanimation, CHU Amiens Picardie, 80000, Amiens, France.
  • Luyt CE; Department of Medical Intensive Care, Caen University Hospital, 14000, Caen, France.
  • Nyunga M; Service de réanimation polyvalente, Centre hospitalier de Valenciennes, Valenciennes, France.
  • Pouly O; Medical Intensive Care Unit, UNIROUEN, Inserm U1096, FHU- REMOD-VHF, Rouen University Hospital, 76000, Rouen, France.
  • Thille AW; Department of Intensive Care, François Mitterrand University Hospital, Dijon, France.
  • Megarbane B; Service de réanimation et de soins intensifs, Centre hospitalier de Douai, Douai, France.
  • Saade A; Service de Médecine Intensive Réanimation, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris Cedex 13, France.
  • Magira E; Service de réanimation, Centre hospitalier de Roubaix, Roubaix, France.
  • Llitjos JF; Service de médecine intensive réanimation, Hôpital Saint Philibert GHICL, Université catholique, Lille, France.
  • Ioannidou I; CHU de Poitiers, Médecine Intensive Réanimation, CIC 1402 ALIVE, Université de Poitiers, Poitiers, France.
  • Pierre A; Department of Medical and Toxicological Critical Care, Lariboisière Hospital, INSERM UMRS-1144, Paris University, Paris, France.
  • Reignier J; Service de médecine intensive réanimation, Hôpital Saint-Louis, 75010, Paris, France.
  • Garot D; First Department of Critical Care Medicine, Medical School, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Kreitmann L; Medical Intensive Care Unit, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
  • Baudel JL; First Department of Pulmonary Medicine and Intensive Care Unit, Sotiria Chest Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Voiriot G; Service de réanimation polyvalente, Centre Hospitalier de Lens, Lens, France.
  • Plantefeve G; Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes, France.
  • Morawiec E; Service de Médecine Intensive Réanimation, CHU de Tours, Hôpital Bretonneau, 37044, Tours Cedex 9, France.
  • Asfar P; Service de Médecine Intensive - Réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69437, Lyon Cedex 03, France.
  • Boyer A; Service de Médecine Intensive Réanimation, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 75012, Paris, France.
  • Mekontso-Dessap A; Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Sorbonne Université, Paris, France.
  • Makris D; Service de réanimation polyvalente, CH Victor Dupouy, Argenteuil, France.
  • Vinsonneau C; Service de Médecine Intensive-Réanimation et Pneumologie, Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • Floch PE; Inserm UMRS Neurophysiologie respiratoire expérimentale et clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France.
  • Marois C; Département de Médecine Intensive Réanimation, CHU d'Angers, 49933, Angers Cedex 9, France.
  • Ceccato A; Service de médecine intensive réanimation, CHU de Bordeaux, 33000Bordeaux, France.
  • Artigas A; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Service de Médecine Intensive Réanimation, CARMAS ; INSERM U955, Institut Mondor de recherche Biomédicale, Université Paris Est Créteil, 94010, Créteil, France.
  • Gaudet A; Intensive Care Unit, University Hospital of Larissa, University of Thessaly, 41110, Biopolis Larissa, Greece.
  • Nora D; Intensive Care Unit, Hôpital de Béthune, 62408, Béthune, France.
  • Cornu M; Service de réanimation, Hôpital Duchenne, 62200, Boulogne-sur-Mer, France.
  • Duhamel A; Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Département de Neurologie, Unité de Médecine Intensive Réanimation Neurologique, Sorbonne Université, Paris, France.
  • Labreuche J; Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, INSERM UMR_S 938, Centre de recherche Saint-Antoine, Maladies métaboliques, biliaires et fibro-inflammatoire du foie, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Paris, France.
  • Nseir S; Intensive Care Unit, IDIBAPS, CIBERES, Hospital Universitari Sagrat Cor, Barcelona, Spain.
Crit Care ; 26(1): 11, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1607559
ABSTRACT

BACKGROUND:

Recent multicenter studies identified COVID-19 as a risk factor for invasive pulmonary aspergillosis (IPA). However, no large multicenter study has compared the incidence of IPA between COVID-19 and influenza patients.

OBJECTIVES:

To determine the incidence of putative IPA in critically ill SARS-CoV-2 patients, compared with influenza patients.

METHODS:

This study was a planned ancillary analysis of the coVAPid multicenter retrospective European cohort. Consecutive adult patients requiring invasive mechanical ventilation for > 48 h for SARS-CoV-2 pneumonia or influenza pneumonia were included. The 28-day cumulative incidence of putative IPA, based on Blot definition, was the primary outcome. IPA incidence was estimated using the Kalbfleisch and Prentice method, considering extubation (dead or alive) within 28 days as competing event.

RESULTS:

A total of 1047 patients were included (566 in the SARS-CoV-2 group and 481 in the influenza group). The incidence of putative IPA was lower in SARS-CoV-2 pneumonia group (14, 2.5%) than in influenza pneumonia group (29, 6%), adjusted cause-specific hazard ratio (cHR) 3.29 (95% CI 1.53-7.02, p = 0.0006). When putative IPA and Aspergillus respiratory tract colonization were combined, the incidence was also significantly lower in the SARS-CoV-2 group, as compared to influenza group (4.1% vs. 10.2%), adjusted cHR 3.21 (95% CI 1.88-5.46, p < 0.0001). In the whole study population, putative IPA was associated with significant increase in 28-day mortality rate, and length of ICU stay, compared with colonized patients, or those with no IPA or Aspergillus colonization.

CONCLUSIONS:

Overall, the incidence of putative IPA was low. Its incidence was significantly lower in patients with SARS-CoV-2 pneumonia than in those with influenza pneumonia. Clinical trial registration The study was registered at ClinicalTrials.gov, number NCT04359693 .
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Influenza, Human / Invasive Pulmonary Aspergillosis / COVID-19 / Intubation Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2022 Document Type: Article Affiliation country: S13054-021-03874-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Influenza, Human / Invasive Pulmonary Aspergillosis / COVID-19 / Intubation Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2022 Document Type: Article Affiliation country: S13054-021-03874-1