PMC:7265874 / 1705-4600 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7265874","sourcedb":"PMC","sourceid":"7265874","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7265874","text":"Between March 12th and April 25th 2020, 34 COVID-19 patients were admitted to our ICU, of whom 20 (59%) required invasive mechanical ventilation. Seven of these ventilated patients (35%) were suspected of IPA (Table 1). Median age in our patient cohort was 66 (interquartile range 56–77) years. Underlying comorbidities were primarily cardiovascular. Only three patients were immunocompromised. One patient received chronic corticosteroid treatment for pemphigus foliaceous, one patient was HIV-positive (CD4 count \u003e 250; viral load \u003c 20 copies, treated with antiretrovirals [lamivudine/tenofovir/nevirapine]) and one patient had been treated for acute myeloid leukaemia 8 years ago and had developed IPA during chemotherapy. All patients were intubated and mechanically ventilated due to severe COVID-19 pneumonia.\nTable 1 Patients with suspected IPA\nPatient ID Sex (M/F) Age Medical history Time between COVID-19 symptoms and ICU admission (days) Time between COVID-19 symptoms and intubation (days) Time between intubation and first finding of IPA (days) First BAL galactomannan index Peak BAL galactomannan index First serum galactomannan index Peak serum galactomannan index\n1 M 86 Hyperchol 7 7 9 N/A N/A 0.10 0.10\n2 M 38 Obesity, hyperchol 9 9 6 2.40 \u003e 2.80 0.30 0.30\n3 M 62 DM 7 7 16 0.72 2.00 0.20 0.20\n4 M 73 DM, obesity, AHT, hyperchol 9 10 5 2.65 \u003e 2.80 0.10 0.10\n5 M 77 DM, CKD, AHT, pemphigus foliaceus 9 10 2 2.79 2.79 0.10 0.10\n6 M 55 HIV, AHT, hyperchol 8 9 13 0.69 0.69 0.18 0.80\n7 M 75 AML, IPA (2012) 3 3 8 2.63 2.63 N/A N/A\nPatient ID Sex (M/F) Age Medical history First positive culture CT scan Histological examinationa IPA diagnosis AspICU algorithm Antifungal therapy Outcome\n1 M 86 Hyperchol A. flavus (ETA) No scan available N/A – – None Died, ICU day 10\n2 M 38 Obesity, hyperchol A. fumigatus (BAL) + Positive Proven Absolute Voriconazole, isavuconazole Alive on MV, ICU day 28b\n3 M 62 DM A. fumigatus (BAL) No scan available Positive Proven Absolute Voriconazole Died, ICU day 20\n4 M 73 DM, obesity, AHT, hyperchol A. fumigatus (BAL) No scan available Positive Proven Absolute Voriconazole Alive on MV, ICU day 24b\n5 M 77 DM, CKD, AHT, pemphigus foliaceus A. fumigatus (BAL) No scan available Positive Proven Absolute Voriconazole Alive on MV, ICU day 21b\n6 M 55 HIV, AHT, hyperchol Negative No scan available Negative – Voriconazole, isavuconazole Died, ICU day 27\n7 M 75 AML, IPA (2012) A. fumigatus (BAL) No scan available N/A – Voriconazole Died, ICU day 8\nCKD chronic kidney disease, AML acute myeloid leukaemia, IPA invasive pulmonary aspergillosis. N/A no sample available, Hyperchol hypercholesterolaemia, AHT arterial hypertension, DM diabetes mellitus, BAL bronchoalveolar lavage, ETA endotracheal aspirate, MV mechanical ventilation arterial hypertension\naAnatomopathological examination of tissue samples obtained via bronchoscopy\nbAt the time of 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