PMC:7646269 / 3376-5336 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7646269","sourcedb":"PMC","sourceid":"7646269","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7646269","text":"A total of seven patients with COVID‐19 who had one or more positive respiratory cultures for Aspergillus fumigatus were identified. According to the AspICU algorithm, 7 four patients were classified as putative IPA. None of the patients had European Organization for Research and Treatment of Cancer/ Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) host factors, including neutropenia and prolonged use of corticosteroids. Only one patient had a pre‐existing lung disease (chronic obstructive pulmonary disease in Patient 1). All four patients had compatible signs (fever refractory to at least 3 days of appropriate therapy or worsening respiratory insufficiency despite appropriate antibiotic therapy and ventilatory support), host factor (glucocorticoid treatment with prednisone equivalent \u003e 20 mg/d) and abnormal radiographic findings. Radiographic abnormalities included worsening infiltrates (Patient 1), opacities with dense consolidations (Patient 2), cavitary pneumonia (Patient 3) and diffuse interstitial and patchy hazy opacities (Patient 4). The remaining three patients were classified as having colonisation as they lacked compatible clinical signs. For those three patients, subsequent clinical deterioration was explained by other causes. Clinical characteristics of the patients with putative IPA are shown in Table 1. The median age was 79 years. All experienced worsening respiratory status leading to invasive mechanical ventilation before the isolation of Aspergillus fumigatus. The patients had been mechanically ventilated for a mean of 6.8 days (range: 1‐14 days) before Aspergillus isolation. At Aspergillus isolation, fever and leukocytosis were present in one and all four patients, respectively. Serum galactomannan level was positive for only one patient (Patient 2). All patients received concomitant broad‐spectrum antibiotic 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