tetano
Editor, Senior Moderator
Emerg Infect Dis
. 2020 Oct 21;27(1).
doi: 10.3201/eid2701.202896. Online ahead of print.
Aspergillosis Complicating Severe Coronavirus Disease
Kieren A Marr, Andrew Platt, Jeffrey A Tornheim, Sean X Zhang, Kausik Datta, Celia Cardozo, Carolina Garcia-Vidal
Abstract
Aspergillosis complicating severe influenza infection has been increasingly detected worldwide. Recently, coronavirus disease-associated pulmonary aspergillosis (CAPA) has been detected through rapid reports, primarily from centers in Europe. We provide a case series of CAPA, adding 20 cases to the literature, with review of pathophysiology, diagnosis, and outcomes. The syndromes of pulmonary aspergillosis complicating severe viral infections are distinct from classic invasive aspergillosis, which is recognized most frequently in persons with neutropenia and in other immunocompromised persons. Combined with severe viral infection, aspergillosis comprises a constellation of airway-invasive and angio-invasive disease and results in risks associated with poor airway fungus clearance and killing, including virus- or inflammation-associated epithelial damage, systemic immunosuppression, and underlying lung disease. Radiologic abnormalities can vary, reflecting different pathologies. Prospective studies reporting poor outcomes in CAPA patients underscore the urgent need for strategies to improve diagnosis, prevention, and therapy.
Keywords: Aspergillus; COVID-19; SARS-CoV-2; aspergillosis; complications; coronavirus disease; fungal infections; fungi; respiratory infections; severe acute respiratory syndrome coronavirus 2; severe viral pneumonia; zoonoses.
. 2020 Oct 21;27(1).
doi: 10.3201/eid2701.202896. Online ahead of print.
Aspergillosis Complicating Severe Coronavirus Disease
Kieren A Marr, Andrew Platt, Jeffrey A Tornheim, Sean X Zhang, Kausik Datta, Celia Cardozo, Carolina Garcia-Vidal
- PMID: 33084566
- DOI: 10.3201/eid2701.202896
Abstract
Aspergillosis complicating severe influenza infection has been increasingly detected worldwide. Recently, coronavirus disease-associated pulmonary aspergillosis (CAPA) has been detected through rapid reports, primarily from centers in Europe. We provide a case series of CAPA, adding 20 cases to the literature, with review of pathophysiology, diagnosis, and outcomes. The syndromes of pulmonary aspergillosis complicating severe viral infections are distinct from classic invasive aspergillosis, which is recognized most frequently in persons with neutropenia and in other immunocompromised persons. Combined with severe viral infection, aspergillosis comprises a constellation of airway-invasive and angio-invasive disease and results in risks associated with poor airway fungus clearance and killing, including virus- or inflammation-associated epithelial damage, systemic immunosuppression, and underlying lung disease. Radiologic abnormalities can vary, reflecting different pathologies. Prospective studies reporting poor outcomes in CAPA patients underscore the urgent need for strategies to improve diagnosis, prevention, and therapy.
Keywords: Aspergillus; COVID-19; SARS-CoV-2; aspergillosis; complications; coronavirus disease; fungal infections; fungi; respiratory infections; severe acute respiratory syndrome coronavirus 2; severe viral pneumonia; zoonoses.