COVID-19 associated pulmonary aspergillosis

Philipp Koehler; Oliver A Cornely; Bernd W Böttiger; Fabian Dusse; Dennis A Eichenauer; Frieder Fuchs; Michael Hallek; Norma Jung; Florian Klein; Thorsten Persigehl; Jan Rybniker; Matthias Kochanek; Boris Böll; Alexander Shimabukuro-Vornhagen

doi:10.1111/myc.13096

COVID-19 associated pulmonary aspergillosis

Mycoses. 2020 Jun;63(6):528-534. doi: 10.1111/myc.13096. Epub 2020 May 15.

Authors

Philipp Koehler^{1

2}, Oliver A Cornely^{1

2

3

4}, Bernd W Böttiger⁵, Fabian Dusse⁵, Dennis A Eichenauer¹, Frieder Fuchs⁶, Michael Hallek¹, Norma Jung¹, Florian Klein⁷, Thorsten Persigehl⁸, Jan Rybniker¹, Matthias Kochanek¹, Boris Böll¹, Alexander Shimabukuro-Vornhagen¹

Affiliations

¹ Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.
² Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
³ ZKS Köln, Clinical Trials Centre Cologne, Cologne, Germany.
⁴ German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Department of Anesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁶ Faculty of Medicine, Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany.
⁷ Institute of Virology, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁸ Department of Radiology, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.

Abstract

Objectives: Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates coronavirus disease 19 (COVID-19) associated invasive aspergillosis at a single centre in Cologne, Germany.

Methods: A retrospective chart review of all patients with COVID-19 associated ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Cologne, Germany.

Results: COVID-19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS.

Conclusion: Clinicians caring for patients with ARDS due to COVID-19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co-infection.

Keywords: Aspergillus; ECMO; ICU; SARS-CoV-2; isavuconazole; voriconazole.

Publication types

Case Reports

MeSH terms

Aged
Antifungal Agents / therapeutic use
Bronchoalveolar Lavage Fluid / chemistry
Bronchoalveolar Lavage Fluid / virology
COVID-19
Coronavirus Infections / complications*
Coronavirus Infections / diagnostic imaging
Female
Galactose / analogs & derivatives
Germany
Hemorrhage / etiology
Hospitals, Teaching
Humans
Intensive Care Units
Lung Diseases / etiology
Male
Mannans / analysis
Metapneumovirus / isolation & purification
Middle Aged
Nitriles / therapeutic use
Pandemics
Paramyxoviridae Infections / etiology
Pneumonia, Viral / complications*
Pneumonia, Viral / diagnostic imaging
Pulmonary Aspergillosis / complications*
Pulmonary Aspergillosis / diagnostic imaging
Pyridines / therapeutic use
Respiratory Distress Syndrome / complications*
Respiratory Distress Syndrome / diagnostic imaging
Retrospective Studies
Thorax / diagnostic imaging
Tomography, X-Ray Computed
Triazoles / therapeutic use
Voriconazole / therapeutic use

Substances

Antifungal Agents
Mannans
Nitriles
Pyridines
Triazoles
galactomannan
isavuconazole
Voriconazole
Galactose