Interdisciplinary Department of Medicine, Hygiene Section, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
Int J Environ Res Public Health. 2022 Jun 9;19(12):7079. doi: 10.3390/ijerph19127079.
Aspergillosis is a disease caused by , and invasive pulmonary aspergillosis (IPA) is the most common invasive fungal infection leading to death in severely immuno-compromised patients. The literature reports co-infections in patients with COVID-19 (CAPA). Diagnosing CAPA clinically is complex since the symptoms are non-specific, and performing a bronchoscopy is difficult. Generally, the microbiological diagnosis of aspergillosis is based on cultural methods and on searching for the circulating antigens galactomannan and 1,3-β-D-glucan in the bronchoalveolar lavage fluid (bGM) or serum (sGM). In this study, to verify whether the COVID-19 period has stimulated clinicians to pay greater attention to IPA in patients with respiratory tract infections, we evaluated the number of requests for GM-Ag research and the number of positive tests found during the pre-COVID-19 and COVID-19 periods. Our data show a significant upward trend in GM-Ag requests and positivity from the pre-COVID to COVID period, which is attributable in particular to the increase in IPA risk factors as a complication of COVID-19. In the COVID period, parallel to the increase in requests, the number of positive tests for GM-Ag also increased, going from 2.5% in the first period of 2020 to 12.3% in the first period of 2021.
曲霉菌病是由曲霉菌引起的疾病，侵袭性肺曲霉病（IPA）是导致严重免疫功能低下患者死亡的最常见侵袭性真菌感染。文献报道 COVID-19（CAPA）患者存在合并感染。由于症状不特异，临床诊断 CAPA 较为复杂，且支气管镜检查较为困难。一般来说，曲霉病的微生物学诊断基于培养方法以及检测支气管肺泡灌洗液（bGM）或血清（sGM）中半乳甘露聚糖和 1,3-β-D-葡聚糖的循环抗原。在这项研究中，为了验证 COVID-19 期间是否促使临床医生更加关注呼吸道感染患者的 IPA，我们评估了 GM-Ag 研究的请求数量和在 COVID-19 之前和期间发现的阳性测试数量。我们的数据显示，从 COVID-19 之前到 COVID-19 期间，GM-Ag 请求和阳性率呈显著上升趋势，这主要归因于 COVID-19 并发症 IPA 风险因素的增加。在 COVID-19 期间，与请求数量的增加平行，GM-Ag 阳性测试的数量也从 2020 年第一季度的 2.5%增加到 2021 年第一季度的 12.3%。
