4.6 Review

Invasive Fungal Infections Associated with COVID-19

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Summary: Cases of COVID-19-associated pulmonary aspergillosis (CAPA) were reported early in the pandemic, but it remains challenging to diagnose. The clinical and radiological manifestations of CAPA are similar to severe COVID-19, so mycological evidence is crucial for diagnosis. However, blood tests lack sensitivity in early stages and mortality rates are high even with antifungal therapy. Testing bronchoalveolar lavage (BAL) is essential for accurate diagnosis.

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Summary: Diagnosing CAPA poses challenges due to the lack of standardized algorithms and definitions, reluctance among clinicians to perform aerosol-generating bronchoalveolar lavages for testing, and uncertainty surrounding the diagnostic sensitivity of serum biomarkers. The study highlights the importance of a multimodal diagnostic approach involving regular and repeat testing of both serum and respiratory samples when diagnosing CAPA.

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