Your browser doesn't support javascript.
Prognostic Impact of Bronchoalveolar Lavage Fluid Galactomannan and Aspergillus Culture Results on Survival in COVID-19 Intensive Care Unit Patients: a Post Hoc Analysis from the European Confederation of Medical Mycology (ECMM) COVID-19-Associated Pulmonary Aspergillosis Study.
Giacobbe, Daniele Roberto; Prattes, Juergen; Wauters, Joost; Dettori, Silvia; Signori, Alessio; Salmanton-García, Jon; Maertens, Johan; Bourgeois, Marc; Reynders, Marijke; Rutsaert, Lynn; Van Regenmortel, Niels; Lormans, Piet; Feys, Simon; Klimko, Nikolay; Shadrivova, Olga; Cornely, Oliver A; Rautemaa-Richardson, Riina; Koehler, Philipp; Lagrou, Katrien; Bassetti, Matteo; Hoenigl, Martin.
  • Giacobbe DR; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Prattes J; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
  • Wauters J; Medical University of Grazgrid.11598.34, Division of Infectious Diseases, Excellence Centre for Medical Mycology (ECMM), Graz, Austria.
  • Dettori S; Universitair Ziekenhuis Leuven, Leuven, Belgium.
  • Signori A; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Salmanton-García J; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
  • Maertens J; Section of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Bourgeois M; University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany.
  • Reynders M; University of Cologne, Medical Faculty and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.
  • Rutsaert L; Universitair Ziekenhuis Leuven, Leuven, Belgium.
  • Van Regenmortel N; Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Bruges, Belgium.
  • Lormans P; Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Bruges, Belgium.
  • Feys S; Ziekenhusnetwerk Antwerp, Antwerp, Belgium.
  • Klimko N; Ziekenhusnetwerk Antwerp, Antwerp, Belgium.
  • Shadrivova O; Algemeen Ziekenhuis Delta, Roeselare, Belgium.
  • Cornely OA; Universitair Ziekenhuis Leuven, Leuven, Belgium.
  • Rautemaa-Richardson R; I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation.
  • Koehler P; I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation.
  • Lagrou K; University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany.
  • Bassetti M; University of Cologne, Medical Faculty and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.
  • Hoenigl M; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.
J Clin Microbiol ; 60(4): e0229821, 2022 04 20.
Article in English | MEDLINE | ID: covidwho-1759280
ABSTRACT
Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used as a survival proxy remains unknown. We conducted a post hoc analysis of a previous multicenter, multinational observational study with the aim of assessing the differential prognostic impact of BALF mycological tests, namely, positive (optical density index of ≥1.0) BALF galactomannan (GM) and positive BALF Aspergillus culture alone or in combination for critically ill patients with COVID-19. Of the 592 critically ill patients with COVID-19 enrolled in the main study, 218 were included in this post hoc analysis, as they had both test results available. CAPA was diagnosed in 56/218 patients (26%). Most cases were probable CAPA (51/56 [91%]) and fewer were proven CAPA (5/56 [9%]). In the final multivariable model adjusted for between-center heterogeneity, an independent association with 90-day mortality was observed for the combination of positive BALF GM and positive BALF Aspergillus culture in comparison with both tests negative (hazard ratio, 2.53; 95% CI confidence interval [CI], 1.28 to 5.02; P = 0.008). The other independent predictors of 90-day mortality were increasing age and active malignant disease. In conclusion, the combination of positive BALF GM and positive BALF Aspergillus culture was associated with increased 90-day mortality in critically ill patients with COVID-19. Additional study is needed to explore the possible prognostic value of other BALF markers.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Aspergillosis / Invasive Pulmonary Aspergillosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: J Clin Microbiol Year: 2022 Document Type: Article Affiliation country: Jcm.02298-21

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Aspergillosis / Invasive Pulmonary Aspergillosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: J Clin Microbiol Year: 2022 Document Type: Article Affiliation country: Jcm.02298-21