Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study
Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-10-01
|
| Series: | Pathogens |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-0817/10/11/1370 |
| _version_ | 1797508897874903040 |
|---|---|
| author | Emilien Gregoire Benoit François Pirotte Filip Moerman Antoine Altdorfer Laura Gaspard Eric Firre Martial Moonen Vincent Fraipont Marie Ernst Gilles Darcis |
| author_facet | Emilien Gregoire Benoit François Pirotte Filip Moerman Antoine Altdorfer Laura Gaspard Eric Firre Martial Moonen Vincent Fraipont Marie Ernst Gilles Darcis |
| author_sort | Emilien Gregoire |
| collection | DOAJ |
| description | Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory insufficiency due to COVID-19 from March to December 2020, in order to evaluate the incidence of CAPA and the associated risk factors. We also analysed the diagnostic approach used in our medical centre for CAPA diagnosis. We defined CAPA using recently proposed consensus definitions based on clinical, radiological and microbiological criteria. Probable cases of CAPA occurred in 9 out of 141 patients included in the analysis (6.4%). All cases were diagnosed during the second wave of the pandemic. We observed a significantly higher realization rate of bronchoalveolar lavage (BAL) (51.1% vs. 28.6%, <i>p</i> = 0.01) and <i>Aspergillus</i> testing (through galactomannan, culture, PCR) on BAL samples during the second wave (<i>p</i> < 0.0001). The testing for <i>Aspergillus</i> in patients meeting the clinical and radiological criteria of CAPA increased between the two waves (<i>p</i> < 0.0001). In conclusion, we reported a low but likely underestimated incidence of CAPA in our population. A greater awareness and more systematic testing for <i>Aspergillus</i> are necessary to assess the real incidence and characteristics of CAPA. |
| first_indexed | 2024-03-10T05:11:20Z |
| format | Article |
| id | doaj.art-dba204903184475b9b9803c8b13f8fa6 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-10T05:11:20Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-dba204903184475b9b9803c8b13f8fa62023-11-23T00:52:16ZengMDPI AGPathogens2076-08172021-10-011011137010.3390/pathogens10111370Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational StudyEmilien Gregoire0Benoit François Pirotte1Filip Moerman2Antoine Altdorfer3Laura Gaspard4Eric Firre5Martial Moonen6Vincent Fraipont7Marie Ernst8Gilles Darcis9Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumIntensive Care Unit, Centre Hospitalier Régional (CHR) de Liège, 4000 Liège, BelgiumBiostatistics and Medico-Economic Information Department, Centre Hospitalier Universitaire (CHU) de Liège, 4000 Liege, BelgiumDepartment of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire (CHU) de Liège, 4000 Liège, BelgiumCoronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory insufficiency due to COVID-19 from March to December 2020, in order to evaluate the incidence of CAPA and the associated risk factors. We also analysed the diagnostic approach used in our medical centre for CAPA diagnosis. We defined CAPA using recently proposed consensus definitions based on clinical, radiological and microbiological criteria. Probable cases of CAPA occurred in 9 out of 141 patients included in the analysis (6.4%). All cases were diagnosed during the second wave of the pandemic. We observed a significantly higher realization rate of bronchoalveolar lavage (BAL) (51.1% vs. 28.6%, <i>p</i> = 0.01) and <i>Aspergillus</i> testing (through galactomannan, culture, PCR) on BAL samples during the second wave (<i>p</i> < 0.0001). The testing for <i>Aspergillus</i> in patients meeting the clinical and radiological criteria of CAPA increased between the two waves (<i>p</i> < 0.0001). In conclusion, we reported a low but likely underestimated incidence of CAPA in our population. A greater awareness and more systematic testing for <i>Aspergillus</i> are necessary to assess the real incidence and characteristics of CAPA.https://www.mdpi.com/2076-0817/10/11/1370coronavirus disease 2019 (COVID-19)invasive pulmonary aspergillosis (IPA)COVID-19-associated pulmonary aspergillosis (CAPA)intensive care unit (ICU)bronchoalveolar lavage (BAL)galactomannan (GM) |
| spellingShingle | Emilien Gregoire Benoit François Pirotte Filip Moerman Antoine Altdorfer Laura Gaspard Eric Firre Martial Moonen Vincent Fraipont Marie Ernst Gilles Darcis Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study Pathogens coronavirus disease 2019 (COVID-19) invasive pulmonary aspergillosis (IPA) COVID-19-associated pulmonary aspergillosis (CAPA) intensive care unit (ICU) bronchoalveolar lavage (BAL) galactomannan (GM) |
| title | Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study |
| title_full | Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study |
| title_fullStr | Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study |
| title_full_unstemmed | Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study |
| title_short | Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit—A Monocentric Retrospective Observational Study |
| title_sort | incidence and risk factors of covid 19 associated pulmonary aspergillosis in intensive care unit a monocentric retrospective observational study |
| topic | coronavirus disease 2019 (COVID-19) invasive pulmonary aspergillosis (IPA) COVID-19-associated pulmonary aspergillosis (CAPA) intensive care unit (ICU) bronchoalveolar lavage (BAL) galactomannan (GM) |
| url | https://www.mdpi.com/2076-0817/10/11/1370 |
| work_keys_str_mv | AT emiliengregoire incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT benoitfrancoispirotte incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT filipmoerman incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT antoinealtdorfer incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT lauragaspard incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT ericfirre incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT martialmoonen incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT vincentfraipont incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT marieernst incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy AT gillesdarcis incidenceandriskfactorsofcovid19associatedpulmonaryaspergillosisinintensivecareunitamonocentricretrospectiveobservationalstudy |