COVID-19 Associated Pulmonary Aspergillosis

Mycoses. 2020 Jun;63(6):528-534. doi: 10.1111/myc.13096. Epub 2020 May 15.

Abstract

Objectives: Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates coronavirus disease 19 (COVID-19) associated invasive aspergillosis at a single centre in Cologne, Germany.

Methods: A retrospective chart review of all patients with COVID-19 associated ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Cologne, Germany.

Results: COVID-19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS.

Conclusion: Clinicians caring for patients with ARDS due to COVID-19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co-infection.

Keywords: Aspergillus; ECMO; ICU; SARS-CoV-2; isavuconazole; voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Bronchoalveolar Lavage Fluid / chemistry
  • Bronchoalveolar Lavage Fluid / virology
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnostic imaging
  • Female
  • Germany
  • Hemorrhage / etiology
  • Hospitals, Teaching
  • Humans
  • Intensive Care Units
  • Lung Diseases / etiology
  • Male
  • Mannans / analysis
  • Metapneumovirus / isolation & purification
  • Middle Aged
  • Nitriles / therapeutic use
  • Pandemics
  • Paramyxoviridae Infections / etiology
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnostic imaging
  • Pulmonary Aspergillosis / complications*
  • Pulmonary Aspergillosis / diagnostic imaging
  • Pyridines / therapeutic use
  • Respiratory Distress Syndrome, Adult / complications*
  • Respiratory Distress Syndrome, Adult / diagnostic imaging
  • Retrospective Studies
  • Thorax / diagnostic imaging
  • Tomography, X-Ray Computed
  • Triazoles / therapeutic use
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Mannans
  • Nitriles
  • Pyridines
  • Triazoles
  • galactomannan
  • isavuconazole
  • Voriconazole

Supplementary concepts

  • COVID-19