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COVID-19 相关危重症患者的肺部曲霉病。

Pulmonary aspergillosis in critically ill patients with Coronavirus Disease 2019 (COVID-19).

机构信息

Institut des Agents Infectieux, Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, F-69004, France.

Physiologie intégrée du système d'éveil, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Faculté de Médecine, Université Claude Bernard Lyon 1, Bron, F-69500, France.

出版信息

Med Mycol. 2021 Jan 4;59(1):110-114. doi: 10.1093/mmy/myaa078.

Abstract

UNLABELLED

Occurrence of putative invasive pulmonary aspergillosis was screened in 153 consecutive adult intensive care unit (ICU) patients with respiratory samples addressed for mycological diagnosis during a 6-week period at the emergence of coronavirus disease 2019 (COVID-19) pandemic. Positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) was observed for 106 patients (69.3%). Nineteen of them (17.9%) with positive Aspergillus results were considered as having putative invasive pulmonary aspergillosis. These observations underline the risk of pulmonary aspergillosis in COVID-19 patients, even in patients not previously known to be immunosuppressed, advocating active search for Aspergillus infection and prompt antifungal treatment. Standardized surveillance protocols and updated definitions for ICU putative invasive pulmonary aspergillosis are needed.

LAY ABSTRACT

Adult ICU patients with respiratory samples addressed for mycological diagnosis were screened during the emergence of COVID-19 pandemic. Positive SARS-CoV-2 PCR was observed for 106 patients, nineteen of them (17.9%) having aspergillosis. This underlines the risk of aspergillosis in COVID-19 patients.

摘要

背景

在 2019 年冠状病毒病(COVID-19)大流行期间,对出现的 153 例连续成年重症监护病房(ICU)患者的呼吸道样本进行了疑似侵袭性肺曲霉病的筛查,这些患者的呼吸道样本都进行了真菌学诊断。

方法

对呼吸道样本进行了疑似侵袭性肺曲霉病的筛查,这些患者的呼吸道样本都进行了真菌学诊断。

结果

106 例患者的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)聚合酶链反应(PCR)为阳性(69.3%)。19 例(17.9%)有曲霉菌阳性结果的患者被认为患有疑似侵袭性肺曲霉病。

结论

这些观察结果强调了 COVID-19 患者发生肺曲霉病的风险,即使是以前未被认为免疫功能低下的患者,也需要积极寻找曲霉菌感染并及时进行抗真菌治疗。需要制定标准化的 ICU 疑似侵袭性肺曲霉病监测方案和更新的定义。

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