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COVID‐19‐associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID‐19 pneumonia: An observational study from Pakistan
- Source :
- Mycoses
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background Invasive aspergillosis is a well-known complication of severe influenza pneumonia with acute respiratory distress syndrome (ARDS). However, recent studies are reporting emergence of aspergillosis in severe COVID-19 pneumonia, named as COVID-19-associated pulmonary aspergillosis (CAPA). Methods A retrospective observational study was conducted in patients with severe COVID-19 pneumonia from February 2020 to April 2020. Patients ≥18 years of age with clinical features and abnormal chest imaging with confirmed COVID-19 by RT-PCR for SARS-CoV-2 were included. CAPA was diagnosed based on clinical parameters, radiological findings and mycological data. Data were recorded on a structured proforma, and descriptive analysis was performed using Stata ver 12.1. Results A total of 147 patients with confirmed COVID-19 and 23 (15.6%) patients requiring ICU admission were identified. Aspergillus species were isolated from tracheal aspirates of nine (39.1%) patients, and of these, five patients (21.7%) were diagnosed with CAPA and four (17.4%) had Aspergillus colonisation. The mean age of patients with CAPA was 69 years (Median age: 71, IQR: 24, Range: 51-85), and 3/5 patients were male. The most frequent co-morbid was diabetes mellitus (4/5). The overall fatality rate of COVID-19 patients with aspergillosis was 44% (4/9). The cause of death was ARDS in all three patients with CAPA, and the median length of stay was 16 days (IQR: 10; Range 6-35 days). Conclusion This study highlights the need for comparative studies to establish whether there is an association of aspergillosis and COVID-19 and the need for screening for fungal infections in severe COVID-19 patients with certain risk factors.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
ARDS
COVID‐19 associated aspergillosis
Pneumonia, Viral
030106 microbiology
Dermatology
Azithromycin
Aspergillosis
Diabetes Complications
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Risk Factors
Nasopharynx
Internal medicine
Diabetes mellitus
Case fatality rate
Humans
Medicine
Pakistan
Pandemics
Aged
Retrospective Studies
Cause of death
Aged, 80 and over
Invasive Pulmonary Aspergillosis
invasive aspergillosis
Respiratory Distress Syndrome
ICU admission
business.industry
severe COVID‐19
COVID-19
Retrospective cohort study
Original Articles
General Medicine
Middle Aged
medicine.disease
Pneumonia
Infectious Diseases
Original Article
Female
Coronavirus Infections
business
Complication
Hydroxychloroquine
Subjects
Details
- ISSN :
- 14390507 and 09337407
- Volume :
- 63
- Database :
- OpenAIRE
- Journal :
- Mycoses
- Accession number :
- edsair.doi.dedup.....dcdd67c1974dcb42cf07910ee9477e7c