학술논문
Influenza- and COVID-19-Associated Pulmonary Aspergillosis: Are the Pictures Different?
Document Type
article
Author
Florian Reizine; Kieran Pinceaux; Mathieu Lederlin; Brice Autier; Hélène Guegan; Arnaud Gacouin; David Luque-Paz; Christelle Boglione-Kerrien; Astrid Bacle; Brendan Le Daré; Yoann Launey; Mathieu Lesouhaitier; Benoit Painvin; Christophe Camus; Alexandre Mansour; Florence Robert-Gangneux; Sorya Belaz; Yves Le Tulzo; Jean-Marc Tadié; Adel Maamar; Jean-Pierre Gangneux
Source
Journal of Fungi, Vol 7, Iss 5, p 388 (2021)
Subject
Language
English
ISSN
2309-608X
Abstract
Invasive pulmonary aspergillosis (IPA) in intensive care unit patients is a major concern. Influenza-associated acute respiratory distress syndrome (ARDS) and severe COVID-19 patients are both at risk of developing invasive fungal diseases. We used the new international definitions of influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) to compare the demographic, clinical, biological, and radiological aspects of IAPA and CAPA in a monocentric retrospective study. A total of 120 patients were included, 71 with influenza and 49 with COVID-19-associated ARDS. Among them, 27 fulfilled the newly published criteria of IPA: 17/71 IAPA (23.9%) and 10/49 CAPA (20.4%). Kaplan–Meier curves showed significantly higher 90-day mortality for IPA patients overall (p = 0.032), whereas mortality did not differ between CAPA and IAPA patients. Radiological findings showed differences between IAPA and CAPA, with a higher proportion of features suggestive of IPA during IAPA. Lastly, a wide proportion of IPA patients had low plasma voriconazole concentrations with a higher delay to reach concentrations > 2 mg/L in CAPA vs. IAPA patients (p = 0.045). Severe COVID-19 and influenza patients appeared very similar in terms of prevalence of IPA and outcome. The dramatic consequences on the patients’ prognosis emphasize the need for a better awareness in these particular populations.