Anticipatory Antifungal Treatment in Critically Ill Patients with SARS-CoV-2 Pneumonia

The aim of this study was to investigate the incidence of COVID-19-associated pulmonary aspergillosis (CAPA) in critically ill patients and the impact of anticipatory antifungal treatment on the incidence of CAPA in critically ill patients. Before/after observational study in a mixed intensive care...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2023-02, Vol.9 (3), p.288
Main Authors: Estella, Ángel, Recuerda Núñez, María, Lagares, Carolina, Gracia Romero, Manuel, Torres, Eva, Alados Arboledas, Juan Carlos, Antón Escors, Álvaro, González García, Clara, Sandar Núñez, Dolores, López Prieto, Dolores, Sánchez Calvo, Juan Manuel
Format: Article
Language:English
Subjects:
Antifungal agents
ARDS
Aspergillosis
aspergillus
Bacterial pneumonia
bronchoalveolar lavage
Bronchoscopy
Care and treatment
Comparative analysis
COVID-19
Health aspects
Hemodynamics
Hospitals
ICU
Infections
Influenza
Laboratories
Lavage
liposomal amphotericin B
Mechanical ventilation
Medical research
Medicine, Experimental
Mortality
Pandemics
Patients
Pneumonia
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Spain
Stains & staining
Steroids
Survival analysis
Variables
Ventilation
Ventilators
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Summary:The aim of this study was to investigate the incidence of COVID-19-associated pulmonary aspergillosis (CAPA) in critically ill patients and the impact of anticipatory antifungal treatment on the incidence of CAPA in critically ill patients. Before/after observational study in a mixed intensive care unit (ICU) of a university teaching hospital. The study took place between March 2020 and June 2022. Inclusion criteria were critically ill patients with severe SARS-CoV-2 pneumonia requiring invasive mechanical ventilation. Two analysis periods were compared according to whether or not antifungal therapy was given early. A total of 160 patients with severe SARS-CoV-2 pneumonia and invasive mechanical ventilation were included. The incidence of CAPA in the first study period was 19 out of 58 patients (32.75%); during the second period, after implementation of the intervention (anticipatory antifungal therapy), the incidence of CAPA decreased to 10.78% (11 out of 102 patients). In patients with CAPA under invasive mechanical ventilation, the mortality rate decreased from 100% to 64%. Anticipating antifungal treatment in patients with SARS-CoV-2 pneumonia under invasive mechanical ventilation was associated with a decrease in the incidence and mortality of pulmonary aspergillosis.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof9030288