Coronavirus Disease 2019-Associated Pulmonary Aspergillosis in Mechanically Ventilated Patients
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com..
BACKGROUND: Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) occurs in critically ill patients with COVID-19. Risks and outcomes remain poorly understood.
METHODS: A retrospective cohort study of mechanically ventilated adult patients with COVID-19 admitted to 5 Johns Hopkins hospitals was conducted between March and August 2020. CAPA was defined using composite clinical criteria. Fine and Gray competing risks regression was used to analyze clinical outcomes and, multilevel mixed-effects ordinal logistic regression was used to compare longitudinal disease severity scores.
RESULTS: In the cohort of 396 people, 39 met criteria for CAPA. Patients with CAPA were more likely than those without CAPA to have underlying pulmonary vascular disease (41% vs 21.6%, respectively; P = .01), liver disease (35.9% vs 18.2%; P = .02), coagulopathy (51.3% vs 33.1%; P = .03), solid tumors (25.6% vs 10.9%; P = .02), multiple myeloma (5.1% vs 0.3%; P = .03), and corticosteroid exposure during the index admission (66.7% vs 42.6%; P = .005), and had lower body mass indexes (median, 26.6 vs 29.9 [calculated as weight in kilograms divided by height in meters squared]; P = .04). Patients with CAPA had worse outcomes, as measured by ordinal severity of disease scores, requiring longer time to improvement (adjusted odds ratio, 1.081.091.1; P < .001), and advancing in severity almost twice as quickly (subhazard ratio, 1.31.82.5; P < .001). They were intubated twice as long as those without CAPA (subhazard ratio, 0.40.50.6; P < .001) and had longer hospital stays (median [interquartile range], 41.1 [20.5-72.4) vs 18.5 [10.7-31.8] days; P < .001).
CONCLUSION: CAPA is associated with poor outcomes. Attention to preventive measures (screening and/or prophylaxis) is warranted in people with high risk of CAPA.
| Errataetall: |
CommentIn: Clin Infect Dis. 2022 Jan 7;74(1):92-94. - PMID 33754152 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
|---|---|
| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 74(2022), 1 vom: 07. Jan., Seite 83-91 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Permpalung, Nitipong [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Aspergillosis |
|---|
| Anmerkungen: |
Date Completed 14.01.2022 Date Revised 14.01.2022 published: Print CommentIn: Clin Infect Dis. 2022 Jan 7;74(1):92-94. - PMID 33754152 Citation Status MEDLINE |
|---|
| doi: |
10.1093/cid/ciab223 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM322506352 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM322506352 | ||
| 003 | DE-627 | ||
| 005 | 20231225182201.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/cid/ciab223 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1074.xml |
| 035 | |a (DE-627)NLM322506352 | ||
| 035 | |a (NLM)33693551 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Permpalung, Nitipong |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Coronavirus Disease 2019-Associated Pulmonary Aspergillosis in Mechanically Ventilated Patients |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.01.2022 | ||
| 500 | |a Date Revised 14.01.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Clin Infect Dis. 2022 Jan 7;74(1):92-94. - PMID 33754152 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) occurs in critically ill patients with COVID-19. Risks and outcomes remain poorly understood | ||
| 520 | |a METHODS: A retrospective cohort study of mechanically ventilated adult patients with COVID-19 admitted to 5 Johns Hopkins hospitals was conducted between March and August 2020. CAPA was defined using composite clinical criteria. Fine and Gray competing risks regression was used to analyze clinical outcomes and, multilevel mixed-effects ordinal logistic regression was used to compare longitudinal disease severity scores | ||
| 520 | |a RESULTS: In the cohort of 396 people, 39 met criteria for CAPA. Patients with CAPA were more likely than those without CAPA to have underlying pulmonary vascular disease (41% vs 21.6%, respectively; P = .01), liver disease (35.9% vs 18.2%; P = .02), coagulopathy (51.3% vs 33.1%; P = .03), solid tumors (25.6% vs 10.9%; P = .02), multiple myeloma (5.1% vs 0.3%; P = .03), and corticosteroid exposure during the index admission (66.7% vs 42.6%; P = .005), and had lower body mass indexes (median, 26.6 vs 29.9 [calculated as weight in kilograms divided by height in meters squared]; P = .04). Patients with CAPA had worse outcomes, as measured by ordinal severity of disease scores, requiring longer time to improvement (adjusted odds ratio, 1.081.091.1; P < .001), and advancing in severity almost twice as quickly (subhazard ratio, 1.31.82.5; P < .001). They were intubated twice as long as those without CAPA (subhazard ratio, 0.40.50.6; P < .001) and had longer hospital stays (median [interquartile range], 41.1 [20.5-72.4) vs 18.5 [10.7-31.8] days; P < .001) | ||
| 520 | |a CONCLUSION: CAPA is associated with poor outcomes. Attention to preventive measures (screening and/or prophylaxis) is warranted in people with high risk of CAPA | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Aspergillosis | |
| 650 | 4 | |a CAPA | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 700 | 1 | |a Chiang, Teresa Po-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Massie, Allan B |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Sean X |e verfasserin |4 aut | |
| 700 | 1 | |a Avery, Robin K |e verfasserin |4 aut | |
| 700 | 1 | |a Nematollahi, Saman |e verfasserin |4 aut | |
| 700 | 1 | |a Ostrander, Darin |e verfasserin |4 aut | |
| 700 | 1 | |a Segev, Dorry L |e verfasserin |4 aut | |
| 700 | 1 | |a Marr, Kieren A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |d 1992 |g 74(2022), 1 vom: 07. Jan., Seite 83-91 |w (DE-627)NLM012603007 |x 1537-6591 |7 nnns |
| 773 | 1 | 8 | |g volume:74 |g year:2022 |g number:1 |g day:07 |g month:01 |g pages:83-91 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/cid/ciab223 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 74 |j 2022 |e 1 |b 07 |c 01 |h 83-91 | ||