新冠肺炎相关肺曲霉病重症监护病房患者的死亡率
Mortality in ICU Patients with COVID-19-Associated Pulmonary Aspergillosis.
作者信息
Beltrame Anna, Stevens David A, Haiduven Donna
机构信息
College of Public Health, University of South Florida, Tampa, FL 33622, USA.
California Institute for Medical Research, San Jose, CA 95128, USA.
出版信息
J Fungi (Basel). 2023 Jun 20;9(6):689. doi: 10.3390/jof9060689.
A review of 38 studies involving 1437 COVID-19 patients admitted to intensive care units (ICUs) with pulmonary aspergillosis (CAPA) was conducted to investigate whether mortality has improved since the pandemic's onset. The study found that the median ICU mortality was 56.8%, ranging from 30% to 91.8%. These rates were higher for patients admitted during 2020-2021 (61.4%) compared to 2020 (52.3%), and prospective studies found higher ICU mortality (64.7%) than retrospective ones (56.4%). The studies were conducted in various countries and used different criteria to define CAPA. The percentage of patients who received antifungal therapy varied across studies. These results indicate that the mortality rate among CAPA patients is a growing concern, mainly since there has been an overall reduction in mortality among COVID-19 patients. Urgent action is needed to improve prevention and management strategies for CAPA, and additional research is needed to identify optimal treatment strategies to reduce mortality rates among these patients. This study serves as a call to action for healthcare professionals and policymakers to prioritize CAPA, a serious and potentially life-threatening complication of COVID-19.
对38项研究进行了综述,这些研究涉及1437名因肺部曲霉病(CAPA)入住重症监护病房(ICU)的新冠患者,以调查自疫情开始以来死亡率是否有所改善。研究发现,ICU的中位死亡率为56.8%,范围在30%至91.8%之间。与2020年(52.3%)相比,2020 - 2021年期间入院患者的死亡率更高(61.4%),并且前瞻性研究发现ICU死亡率(64.7%)高于回顾性研究(56.4%)。这些研究在不同国家进行,使用了不同标准来定义CAPA。接受抗真菌治疗的患者百分比在各项研究中有所不同。这些结果表明,CAPA患者的死亡率是一个日益令人担忧的问题,主要是因为新冠患者的总体死亡率有所下降。需要采取紧急行动来改善CAPA的预防和管理策略,并且需要更多研究来确定最佳治疗策略以降低这些患者的死亡率。这项研究呼吁医疗保健专业人员和政策制定者将CAPA作为优先事项,CAPA是新冠的一种严重且可能危及生命的并发症。