Arnaud Fekkar1,2, Alexandre Lampros1, Julien Mayaux3, Corentin Poignon1, Sophie Demeret4, Jean-Michel Constantin5, Anne-Geneviève Marcelin6, Antoine Monsel7,8,9, Charles-Edouard Luyt10,11, Marion Blaize1. 1. Parasitologie Mycologie. 2. Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France. 3. Réanimation Médicale. 4. Réanimation Neurologique. 5. Department of Anaesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, DMU DREAM, Sorbonne University, Paris, France. 6. Laboratoire de Virologie. 7. Department of Anesthesiology and Critical Care, Multidisciplinary ICU, and. 8. Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France. 9. Sorbonne Université, INSERM, Immunology Immunopathology Immunotherapy, Paris, France. 10. Service de Médecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France; and. 11. Sorbonne Université, INSERM, Institute of Cardiometabolism and Nutrition, Paris, France.
Abstract
Rationale: Whether severe coronavirus disease (COVID-19) is a significant risk factor for the development of invasive fungal superinfections is of great medical interest and remains, for now, an open question. Objectives: We aim to assess the occurrence of invasive fungal respiratory superinfections in patients with severe COVID-19. Methods: We conducted the study on patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related pneumonia admitted to five ICUs in France who had respiratory and serum sampling performed for specific screening of fungal complications.Measurements and Main Results: The study population included a total of 145 patients; the median age was 55 years old. Most of them were male (n = 104; 72%), were overweight (n = 99; 68%), and had hypertension (n = 83; 57%) and diabetes (n = 46; 32%). Few patients presented preexisting host risk factors for invasive fungal infection (n = 20; 14%). Their global severity was high; all patients were on invasive mechanical ventilation, and half (n = 73, 54%) were on extracorporeal membrane oxygenation support. Mycological analysis included 2,815 mycological tests (culture, galactomannan, β-glucan, and PCR) performed on 475 respiratory samples and 532 sera. A probable/putative invasive pulmonary mold infection was diagnosed in 7 (4.8%) patients and linked to high mortality. Multivariate analysis indicates a significantly higher risk for solid organ transplant recipients (odds ratio, = 4.66; interquartile range, 1.98-7.34; P = 0.004). False-positive fungal test and clinically irrelevant colonization, which did not require the initiation of antifungal treatment, was observed in 25 patients (17.2%).Conclusions: In patients with no underlying immunosuppression, severe SARS-CoV-2-related pneumonia seems at low risk of invasive fungal secondary infection, especially aspergillosis.
Rationale: Whether severe coronavirus disease (COVID-19) is a significant risk factor for the development of invasive fungal superinfections is of great medical interest and remains, for now, an open question. Objectives: We aim to assess the occurrence of invasive fungal respiratory superinfections in patients with severe COVID-19. Methods: We conducted the study on patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related pneumonia admitted to five ICUs in France who had respiratory and serum sampling performed for specific screening of fungal complications.Measurements and Main Results: The study population included a total of 145 patients; the median age was 55 years old. Most of them were male (n = 104; 72%), were overweight (n = 99; 68%), and had hypertension (n = 83; 57%) and diabetes (n = 46; 32%). Few patients presented preexisting host risk factors for invasive fungal infection (n = 20; 14%). Their global severity was high; all patients were on invasive mechanical ventilation, and half (n = 73, 54%) were on extracorporeal membrane oxygenation support. Mycological analysis included 2,815 mycological tests (culture, galactomannan, β-glucan, and PCR) performed on 475 respiratory samples and 532 sera. A probable/putative invasive pulmonary mold infection was diagnosed in 7 (4.8%) patients and linked to high mortality. Multivariate analysis indicates a significantly higher risk for solid organ transplant recipients (odds ratio, = 4.66; interquartile range, 1.98-7.34; P = 0.004). False-positive fungal test and clinically irrelevant colonization, which did not require the initiation of antifungal treatment, was observed in 25 patients (17.2%).Conclusions: In patients with no underlying immunosuppression, severe SARS-CoV-2-related pneumonia seems at low risk of invasive fungal secondary infection, especially aspergillosis.
Authors: A Oliva; G Ceccarelli; C Borrazzo; M Ridolfi; G D 'Ettorre; F Alessandri; F Ruberto; F Pugliese; G M Raponi; A Russo; A Falletta; C M Mastroianni; M Venditti Journal: Infection Date: 2021-05-26 Impact factor: 3.553
Authors: Frank L van de Veerdonk; Roger J M Brüggemann; Shoko Vos; Gert De Hertogh; Joost Wauters; Monique H E Reijers; Mihai G Netea; Jeroen A Schouten; Paul E Verweij Journal: Lancet Respir Med Date: 2021-05-26 Impact factor: 30.700
Authors: Oscar Fernández García; Lorena Guerrero-Torres; Carla M Roman-Montes; Andrea Rangel-Cordero; Areli Martínez-Gamboa; Alfredo Ponce-de-León; María F González-Lara Journal: Med Mycol Case Rep Date: 2021-07-09
Authors: Michael Behal; Brooke Barlow; Breanne Mefford; Melissa L Thompson Bastin; J Chris Donaldson; Melanie Laine; Brittany D Bissell Journal: Crit Care Explor Date: 2021-07-13
Authors: C Gudiol; X Durà-Miralles; J Aguilar-Company; P Hernández-Jiménez; M Martínez-Cutillas; F Fernandez-Avilés; M Machado; L Vázquez; P Martín-Dávila; N de Castro; E Abdala; L Sorli; T M Andermann; I Márquez-Gómez; H Morales; F Gabilán; C M Ayaz; B Kayaaslan; M Aguilar-Guisado; F Herrera; C Royo-Cebrecos; M Peghin; C González-Rico; J Goikoetxea; C Salgueira; A Silva-Pinto; B Gutiérrez-Gutiérrez; S Cuellar; G Haidar; C Maluquer; M Marin; N Pallarès; J Carratalà Journal: J Infect Date: 2021-07-22 Impact factor: 38.637