Salmanton-García Jon, Sprute Rosanne, Stemler Jannik, Bartoletti Michele, Dupont Damien, Valerio Maricela, Garcia-Vidal Carolina, Falces-Romero Iker, Machado Marina, de la Villa Sofía, Schroeder Maria, Hoyo Irma, Hanses Frank, Ferreira-Paim Kennio, Giacobbe Daniele Roberto, Meis Jacques F, Gangneux Jean-Pierre, Rodríguez-Guardado Azucena, Antinori Spinello, Sal Ertan, Malaj Xhorxha, Seidel Danila, Cornely Oliver A, Koehler Philipp
Emerg Infect Dis. 2021;27(4):1077-1086. doi: 10.3201/eid2704.204895. Epub 2021 Feb 4.
Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data from 186 patients who had coronavirus disease-associated pulmonary aspergillosis (CAPA) worldwide during March-August 2020. Overall, 182 patients were admitted to the intensive care unit (ICU), including 180 with acute respiratory distress syndrome and 175 who received mechanical ventilation. CAPA was diagnosed a median of 10 days after coronavirus disease diagnosis. Aspergillus fumigatus was identified in 80.3% of patient cultures, 4 of which were azole-resistant. Most (52.7%) patients received voriconazole. In total, 52.2% of patients died; of the deaths, 33.0% were attributed to CAPA. We found that the cumulative incidence of CAPA in the ICU ranged from 1.0% to 39.1%.
2019年底，严重急性呼吸综合征冠状病毒2引发的肺炎在中国出现。由于该病毒导致严重的免疫调节异常和淋巴细胞减少，以及随后使用针对免疫系统的药物，我们预计患者可能会发生真菌二重感染。我们收集了2020年3月至8月期间全球186例患有冠状病毒病相关肺曲霉病（CAPA）患者的数据。总体而言，182例患者入住重症监护病房（ICU），其中180例患有急性呼吸窘迫综合征，175例接受了机械通气。CAPA在冠状病毒病诊断后中位10天被诊断出来。80.3%的患者培养物中鉴定出烟曲霉，其中4株对唑类耐药。大多数（52.7%）患者接受了伏立康唑治疗。总共有52.2%的患者死亡；在死亡病例中，33.0%归因于CAPA。我们发现ICU中CAPA的累积发病率在1.0%至39.1%之间。
