Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Eur Rev Med Pharmacol Sci. 2022 Jan;26(2):710-714. doi: 10.26355/eurrev_202201_27897.
To study the utility of Galactomannan (GM) antigen as a screening marker for diagnosing invasive pulmonary aspergillosis (IPA) in coronavirus disease 2019 (COVID-19) patients.
The serum samples from patients with severe COVID-19 diseases admitted to the Critical Care Unit were collected on the 5th day of admission for GM screening. The samples were analysed by enzyme linked immune sorbent assay (ELISA) and GM index of more than 1 was considered as positive. All GM positive patients were serially followed until discharge or death.
The GM was raised in serum of 12 out of 38 patients, indicating an incidence of possible COVID-19 associated IPA (CAPA) in 31.57% of patients. The median age of these CAPA patients was 56.5 years, males were significantly more affected than females. The inflammatory marker serum ferritin was raised in all 12 patients (median value of 713.74 ng/ml), while IL-6 was raised in 9 patients (median value of 54.13 ng/ml). None of these patients received antifungals. Their median length of hospital stay was 20 days (IQR: 12, 34 days). All these patients succumbed to the illness.
The serum GM appears to be sensitive diagnostic tool to identify early IPA in COVID-19 patients and pre-emptive antifungal therapy could play a role in salvaging these patients.
研究半乳甘露聚糖（GM）抗原作为 2019 冠状病毒病（COVID-19）患者侵袭性肺曲霉病（IPA）诊断的筛选标志物的效用。
收集重症 COVID-19 患者入院第 5 天的血清样本进行 GM 筛选。采用酶联免疫吸附试验（ELISA）分析样本，GM 指数>1 视为阳性。所有 GM 阳性患者均进行连续随访，直至出院或死亡。
38 例患者中有 12 例 GM 升高，提示可能发生 COVID-19 相关 IPA（CAPA）的患者占 31.57%。这些 CAPA 患者的中位年龄为 56.5 岁，男性受影响明显多于女性。所有 12 例患者的血清铁蛋白炎症标志物升高（中位数为 713.74ng/ml），9 例患者的白细胞介素-6 升高（中位数为 54.13ng/ml）。这些患者均未接受抗真菌治疗。他们的中位住院时间为 20 天（IQR：12，34 天）。所有这些患者都死于疾病。
血清 GM 似乎是识别 COVID-19 患者早期 IPA 的敏感诊断工具，预防性抗真菌治疗可能对挽救这些患者起到作用。
