期刊
EMERGING INFECTIOUS DISEASES
卷 27, 期 4, 页码 1077-1086出版社
CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2704.204895
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资金
- Amplyx Pharmaceuticals, Inc.
- Basilea Pharmaceuticals
- Cidara Therapeutics, Inc.
- F2G Ltd.
- Matinas BioPharma
- Mundipharma International
- Pfizer Inc.
- Astellas Pharma Inc.
- Gilead Sciences Inc.
- MSD Sharp Dohme GmbH
- Medical Faculty of the University of Hamburg, Hamburg, Germany
- MSD Italia Srl
- Philipp Schwartz Initiative of the Alexander von Humboldt Foundation
- German Federal Ministry of Research and Education
- Deutsche Forschungsgemeinschaft under Germany's Excellence Strategy (CECAD) [EXC 2030 -390661388]
- Actelion Pharmaceuticals Global
- Basilea Pharmaceutica International Ltd.
- Da Volterra
- Janssen Pharmaceuticals
- The Medicines Company
- Melinta Therapeutics
- Merck Sharp Dohme Corp.
- Octapharma AG
- Scynexis, Inc.
- Correvio Pharma Corp.
This study found that most patients with coronavirus disease-associated pulmonary aspergillosis (CAPA) are diagnosed shortly after admission, with the majority being treated in the ICU. Azole-resistant strains of Aspergillus fumigatus were common in patients, and voriconazole was the main treatment choice. The overall mortality rate was approximately 52.2%, with about one third of deaths attributed to CAPA.
Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data from 186 patients who had coronavirus disease-associated pulmonary aspergillosis (CAPA) worldwide during March-August 2020. Overall, 182 patients were admitted to the intensive care unit (ICU), including 180 with acute respiratory distress syndrome and 175 who received mechanical ventilation. CAPA was diagnosed a median of 10 days after coronavirus disease diagnosis. Aspergillus fumigatus was identified in 80.3% of patient cultures, 4 of which were azole-resistant. Most (52.7%) patients received voriconazole. In total, 52.2% of patients died; of the deaths, 33.0% were attributed to CAPA. We found that the cumulative incidence of CAPA in the ICU ranged from 1.0% to 39.1%.
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