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Investigation of the value of precipitins in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with a positive marker for Aspergillus species.
Bellanger, A P; Lallemand, S; Tumasyan Horikian, A; Navellou, J C; Barrera, C; Rouzet, A; Scherer, E; Reboux, G; Piton, G; Millon, L.
  • Bellanger AP; Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France.
  • Lallemand S; Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France.
  • Tumasyan Horikian A; CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France.
  • Navellou JC; Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France.
  • Barrera C; Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France.
  • Rouzet A; Intensive Medical Care Unit, Regional Hospital of Besancon, Besancon, France.
  • Scherer E; Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France.
  • Reboux G; Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France.
  • Piton G; CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France.
  • Millon L; Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France.
Med Mycol ; 60(5)2022 May 28.
Article in English | MEDLINE | ID: covidwho-1860885
ABSTRACT
Although a high prevalence of COVID-19-associated pulmonary aspergillosis has been reported, it is still difficult to distinguish between colonization with Aspergillus fumigatus and infection. Concomitantly, similarities between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hypersensitivity pneumonitis were suggested. The objective of this study was to investigate retrospectively if precipitin assays targeting A. fumigatus could have been useful in the management of SARS-CoV-2 patients hospitalized in an Intensive Care Unit (ICU) in 2020. SARS-CoV-2 ICU patients were screened for Aspergillus co-infection using biomarkers (galactomannan antigen, qPCR) and culture of respiratory samples (tracheal aspirates and bronchoalveolar lavage). For all these patients, clinical data, ICU characteristics and microbial results were collected. Electrosyneresis assays were performed using commercial A. fumigatus somatic and metabolic antigens. ELISA were performed using in-house A. fumigatus purified antigen and recombinant antigens.Our study population consisted of 65 predominantly male patients, with a median ICU stay of 22 days, and a global survival rate of 62%. Thirty-five patients had at least one positive marker for Aspergillus species detection. The number of arcs obtained by electrosyneresis using the somatic A. fumigatus antigen was significantly higher for these 35 SARS-CoV-2 ICU patients (P 0.01, Welch's t-test). Our study showed that SARS-CoV-2 ICU patients with a positive marker for Aspergillus species detection more often presented precipitins towards A. fumigatus. Serology assays could be an additional tool to assess the clinical relevance of the Aspergillus species in respiratory samples of SARS-CoV-2 ICU patients. LAY

SUMMARY:

This study showed retrospectively that precipitin assays, such as electrosyneresis, could be helpful to distinguish between colonization and infection with Aspergillus fumigatus during the management of severe acute respiratory syndrome Coronavirus-2 (SARS CoV-2) patients in an intensive care unit.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Invasive Pulmonary Aspergillosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Animals Language: English Journal subject: Veterinary Medicine / Microbiology Year: 2022 Document Type: Article Affiliation country: Mmy

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Invasive Pulmonary Aspergillosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Animals Language: English Journal subject: Veterinary Medicine / Microbiology Year: 2022 Document Type: Article Affiliation country: Mmy