COVID-19-associated aspergillosis in a Brazilian referral centre: Diagnosis, risk factors and outcomes.
Mycoses
; 65(4): 449-457, 2022 Apr.
Article
in English
| MEDLINE | ID: covidwho-1691476
ABSTRACT
BACKGROUND:
COVID-19 patients on mechanical ventilation are at risk to develop invasive aspergillosis. To provide additional data regarding this intriguing entity, we conducted a retrospective study describing risk factors, radiology and prognosis of this emerging entity in a Brazilian referral centre.METHODS:
This retrospective study included intubated (≥18 years) patients with COVID-19 admitted from April 2020 until July 2021 that had bronchoscopy to investigate pulmonary co-infections. COVID-19-associated aspergillosis (CAPA) was defined according to the 2020 European Confederation of Medical Mycology/International Society of Human and Animal Mycosis consensus criteria. The performance of tracheal aspirate (TA) cultures to diagnose CAPA were described, as well as the radiological findings, risk factors and outcomes.RESULTS:
Fourteen patients (14/87, 16%) had probable CAPA (0.9 cases per 100 ICU admissions). The sensitivity, specificity, positive predictive value and negative predictive value of TA for the diagnosis of CAPA were 85.7%, 73.1%, 46.2% and 95% respectively. Most of the radiological findings of CAPA were classified as typical of invasive pulmonary aspergillosis (64.3%). The overall mortality rate of probable CAPA was 71.4%. Age was the only independent risk factor for CAPA [p = .03; odds ratio (OR) 1.072]. CAPA patients under renal replacement therapy (RRT) may have a higher risk for a fatal outcome (p = .053, hazard ratio 8.047).CONCLUSIONS:
CAPA was a prevalent co-infection in our cohort of patients under mechanical ventilation. Older patients had a higher risk to develop CAPA, and a poor prognosis may be associated with RRT.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Invasive Pulmonary Aspergillosis
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Animals
/
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Mycoses
Journal subject:
Microbiology
Year:
2022
Document Type:
Article
Affiliation country:
Myc.13433
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