Aspergillus tracheobronchitis in COVID-19 ARDS patients - a cohort study.

Koehler P, von Stillfried S, Garcia Borrega J, Fuchs F, Salmanton-García J, Pult F, Böll B, Eichenauer DA, Shimabukuro-Vornhagen A, Kurzai O, Boor P, Kochanek M, Cornely OA (2022) Aspergillus tracheobronchitis in COVID-19 ARDS patients - a cohort study. Eur Respir J 59(5), 2103142.

Abstract

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, patients with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 showed a profoundly altered immune system and received immune-modulating therapeutic interventions. This enhanced the susceptibility for fungal superinfections [1, 2]. With the first reports of COVID-19-associated pulmonary aspergillosis (CAPA) the 2020 European Confederation of Medical Mycology (ECMM)/International Society for Human and Animal Mycology (ISHAM) consensus criteria were proposed [3, 4] and Aspergillus tracheobronchitis (ATB) was distinguished as a sub-entity in CAPA [4–6]. During bronchoscopy, ATB presents as ulcerations, pseudomembranes, plaques and eschars, possibly combined with tracheal stenosis [5]. Facing the risk of transmission and SARS-CoV-2 infection of examiners during bronchoscopy, blind suctioning of upper airway samples has been implemented with tracheal aspirates (TA) and non-bronchoscopic lavages. These techniques preclude inspection of the airways, so that ATB cannot be diagnosed beyond the level of suspicion. To study ATB in CAPA patients, we performed a retrospective, single-centre cohort study.

Leibniz-HKI-Autor*innen

Oliver Kurzai

Identifier

doi: 10.1183/13993003.03142-2021

PMID: 35144992