Significance of Aspergillus spp. isolation in defining cases of COVID-19 Associated Pulmonary Aspergillosis - CAPA.

Autor:	Cocio TA; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Ribeirão Preto, SP, Brazil; Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil. Electronic address: alexcocio@gmail.com., Siqueira LPM; Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil., Riciluca KCT; Instituto Adolfo Lutz, Departamento de Coleção de Cultura, São Paulo, SP, Brazil., Gimenes VMF; Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Odontologia, Programa de Pós-Graduação em Diagnostico Bucal, Radiologia Odontológica e Imagiologia, São Paulo, SP, Brazil., de Andrade TS; Instituto Adolfo Lutz, Departamento de Coleção de Cultura, São Paulo, SP, Brazil., Benard G; Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil., Martínez R; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Ribeirão Preto, SP, Brazil., Bollela VR; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Ribeirão Preto, SP, Brazil.
Jazyk:	angličtina
Zdroj:	The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases [Braz J Infect Dis] 2023 Jul-Aug; Vol. 27 (4), pp. 102793. Date of Electronic Publication: 2023 Jul 25.
DOI:	10.1016/j.bjid.2023.102793
Abstrakt:	COVID-19-Associated Pulmonary Aspergillosis (CAPA) is a relatively common complication in patients with severe forms of the disease caused by the SARS-CoV-2 virus. Diagnosing and confirming CAPA is challenging. In this study, Aspergillus spp. isolation in respiratory specimens from patients with COVID-19 was evaluated for identifying cases of CAPA. In 2020‒2021, 17 Aspergillus spp. were isolated from 15 COVID-19 patients admitted to a university hospital in Brazil. Patient records were retrospectively reviewed to obtain clinical-epidemiological data and other markers of Aspergillus spp. infection and then compared with the ECMM/ISHAM criteria for defining CAPA. Probable CAPA was defined in 5/10 patients, who had Aspergillus spp. isolated from Bronchoalveolar Lavage (BAL) or a positive galactomannan blood test. Additionally, anti-Aspergillus antibodies were detected in two of these patients, during active or follow-up phases of CAPA. In another seven patients with Aspergillus spp. isolated from tracheobronchial aspirate or sputum, CAPA was presumed, mainly due to deterioration of clinical conditions and new lung imaging suggestive of fungal infection. Antifungal agents to control CAPA, particularly voriconazole, were used in 9/15 cases. In cases of probable CAPA and remaining patients, clinical conditions and comorbidities were similar, with lethality being high, at 60% and 71%, respectively. The number of CAPA cases defined by scientific criteria was lower than that assumed in the clinical context. This was largely due to the lack of BAL collection for fungal culture and the non-intensive use of other markers of invasive aspergillosis. The isolation of Aspergillus spp. in different respiratory specimens should alert clinicians to the diagnosis of CAPA. Competing Interests: Conflicts of interest The authors declare no conflicts of interest. (Copyright © 2023 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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