학술논문
Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance
Document Type
article
Author
Koehler, Philipp; Bassetti, Matteo; Chakrabarti, Arunaloke; Chen, Sharon CA; Colombo, Arnaldo Lopes; Hoenigl, Martin; Klimko, Nikolay; Lass-Flörl, Cornelia; Oladele, Rita O; Vinh, Donald C; Zhu, Li-Ping; Böll, Boris; Brüggemann, Roger; Gangneux, Jean-Pierre; Perfect, John R; Patterson, Thomas F; Persigehl, Thorsten; Meis, Jacques F; Ostrosky-Zeichner, Luis; White, P Lewis; Verweij, Paul E; Cornely, Oliver A; Mycology, European Confederation of Medical; Mycology, the International Society for Human Animal; Group, the Asia Fungal Working; Group, the INFOCUS LATAM ISHAM Working; Group, the ISHAM Pan Africa Mycology Working; Microbiology, the European Society for Clinical; Group, Infectious Diseases Fungal Infection Study; Patients, the ESCMID Study Group for Infections in Critically Ill; Chemotherapy, the Interregional Association of Clinical Microbiology and Antimicrobial; Society of Nigeria, the Medical Mycology; Association, the Medical Mycology Society of China Medicine Education; Oncology, Infectious Diseases Working Party of the German Society for Haematology and Medical; Microbiology, Association of Medical; Canada, Infectious Disease
Source
The Lancet Infectious Diseases. 21(6)
Subject
Language
Abstract
Severe acute respiratory syndrome coronavirus 2 causes direct damage to the airway epithelium, enabling aspergillus invasion. Reports of COVID-19-associated pulmonary aspergillosis have raised concerns about it worsening the disease course of COVID-19 and increasing mortality. Additionally, the first cases of COVID-19-associated pulmonary aspergillosis caused by azole-resistant aspergillus have been reported. This article constitutes a consensus statement on defining and managing COVID-19-associated pulmonary aspergillosis, prepared by experts and endorsed by medical mycology societies. COVID-19-associated pulmonary aspergillosis is proposed to be defined as possible, probable, or proven on the basis of sample validity and thus diagnostic certainty. Recommended first-line therapy is either voriconazole or isavuconazole. If azole resistance is a concern, then liposomal amphotericin B is the drug of choice. Our aim is to provide definitions for clinical research and up-to-date recommendations for clinical management of the diagnosis and treatment of COVID-19-associated pulmonary aspergillosis.