Koehler Philipp, Bassetti Matteo, Chakrabarti Arunaloke, Chen Sharon C A, Colombo Arnaldo Lopes, Hoenigl Martin, Klimko Nikolay, Lass-Flörl Cornelia, Oladele Rita O, Vinh Donald C, Zhu Li-Ping, Böll Boris, Brüggemann Roger, Gangneux Jean-Pierre, Perfect John R, Patterson Thomas F, Persigehl Thorsten, Meis Jacques F, Ostrosky-Zeichner Luis, White P Lewis, Verweij Paul E, Cornely Oliver A
Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany; Department I of Internal Medicine, European Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Cologne, Germany.
Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, Genoa, Italy; Policlinico San Martino Hospital, Genoa, Italy.
Lancet Infect Dis. 2021 Jun;21(6):e149-e162. doi: 10.1016/S1473-3099(20)30847-1. Epub 2020 Dec 14.
Severe acute respiratory syndrome coronavirus 2 causes direct damage to the airway epithelium, enabling aspergillus invasion. Reports of COVID-19-associated pulmonary aspergillosis have raised concerns about it worsening the disease course of COVID-19 and increasing mortality. Additionally, the first cases of COVID-19-associated pulmonary aspergillosis caused by azole-resistant aspergillus have been reported. This article constitutes a consensus statement on defining and managing COVID-19-associated pulmonary aspergillosis, prepared by experts and endorsed by medical mycology societies. COVID-19-associated pulmonary aspergillosis is proposed to be defined as possible, probable, or proven on the basis of sample validity and thus diagnostic certainty. Recommended first-line therapy is either voriconazole or isavuconazole. If azole resistance is a concern, then liposomal amphotericin B is the drug of choice. Our aim is to provide definitions for clinical research and up-to-date recommendations for clinical management of the diagnosis and treatment of COVID-19-associated pulmonary aspergillosis.
严重急性呼吸综合征冠状病毒2对气道上皮造成直接损伤，从而使曲霉菌得以入侵。新型冠状病毒肺炎相关肺曲霉病的报告引发了人们对其会使新型冠状病毒肺炎病程恶化并增加死亡率的担忧。此外，还报告了首例由耐唑类曲霉菌引起的新型冠状病毒肺炎相关肺曲霉病病例。本文是由专家编写并得到医学真菌学协会认可的关于新型冠状病毒肺炎相关肺曲霉病定义和管理的共识声明。建议根据样本有效性及诊断确定性，将新型冠状病毒肺炎相关肺曲霉病定义为可能、很可能或确诊。推荐的一线治疗药物为伏立康唑或艾沙康唑。如果担心唑类耐药，则脂质体两性霉素B为首选药物。我们的目的是为新型冠状病毒肺炎相关肺曲霉病的临床研究提供定义，并为其诊断和治疗的临床管理提供最新建议。
