LitCovid-sentences  

PMC:7306567 / 26144-32058 JSONTXT 13 Projects

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Id Subject Object Predicate Lexical cue
T194 0-10 Sentence denotes Conclusion
T195 11-213 Sentence denotes IAPA has emerged as a severe complication of influenza, especially in ICU patients, and this secondary infection may occur in any patient, including those considered to be at low risk of developing IPA.
T196 214-312 Sentence denotes The global epidemiology of IAPA may be variable, which might be partly due to underdiagnosis [24].
T197 313-485 Sentence denotes The clinical presentation of IAPA includes invasive Aspergillus tracheobronchitis, which requires bronchoscopic visualization of plaques in the airways to make a diagnosis.
T198 486-623 Sentence denotes Aspergillus culture and BAL GM are positive in > 80% of IAPA cases, and ordering such tests is recommended in influenza cases in the ICU.
T199 624-754 Sentence denotes The proposed case definition relies on an entry criterion based on an influenza-like illness and the detection of influenza virus.
T200 755-958 Sentence denotes The case definition distinguishes between invasive tracheobronchitis and other pulmonary forms of IAPA, with demonstration of invasive fungal hyphae with positive mycology qualifying as proven infection.
T201 959-1075 Sentence denotes Detection of GM or positive Aspergillus culture in BAL is the main mycological criteria in probable case definition.
T202 1076-1371 Sentence denotes The expert group acknowledges that to date still limited data exist to support a definitive approach regarding definitions, diagnosis and treatment of IAPA, but the proposed case definition will facilitate clinical research, will enable valid study comparisons and is essential for surveillance.
T203 1372-1528 Sentence denotes Awareness of IAPA and early antifungal therapy based on high clinical suspicion and Aspergillus diagnostics remains critical to improve the outcome of IAPA.
T204 1530-1613 Sentence denotes Can the IAPA definitions be applied to COVID-19-associated pulmonary aspergillosis?
T205 1614-1831 Sentence denotes Recent reports of IPA cases in coronavirus disease 2019 (COVID-19) patients in the ICU raise the question of whether these IAPA definitions can be applied to COVID-19-associated pulmonary aspergillosis (CAPA) [58–60].
T206 1832-2038 Sentence denotes Although the number of CAPA cases that have been reported is still limited, two recent studies reported putative CAPA cases in 9 of 27 (33%) and 5 of 19 (26%) COVID-19 patients admitted to the ICU [59, 60].
T207 2039-2253 Sentence denotes Although the high number of cases suggests a high risk of developing IPA in COVID-19 patients, there are a number of differences regarding the pathogenesis of SARS-CoV-2 infection compared with influenza (Table 2).
T208 2254-2566 Sentence denotes In influenza patients, there are several factors that are thought to contribute to the risk of IAPA, including the local tissue damage caused by influenza, an immune modulatory effect by suppression of the NADPH oxidase complex and possible effect of treatment with neuraminidase inhibitors, such as oseltamivir.
T209 2567-2712 Sentence denotes In SARS-CoV-2 infection, another receptor is used by the virus to enter human cells, which are not commonly found in the large airways (Table 2).
T210 2713-2810 Sentence denotes Thus, the risk of invasive Aspergillus tracheobronchitis may be lower in CAPA compared with IAPA.
T211 2811-2953 Sentence denotes In addition, there is no known direct immune modulatory effect of SARS-CoV-2, which suggests no virus infection-related increased risk of IPA.
T212 2954-3101 Sentence denotes While IAPA is characterized by rapidly fatal infections with high fungal burden, such course of disease progression has not been reported for CAPA.
T213 3102-3275 Sentence denotes On the contrary, eight of nine CAPA cases reported from a French cohort did not receive antifungal therapy, with a mortality rate similar to COVID-19 cases without IPA [59].
T214 3276-3481 Sentence denotes As, in contrast to IAPA cases, virtually all CAPA cases reported to date are serum GM negative, the question remains if COVID-19 patients develop invasive disease or just become colonized with Aspergillus.
T215 3482-3697 Sentence denotes It is possible that COVID-19 is in itself not a risk factor for IPA, but that the risk is associated with other risk factors related to treatment such as administration of corticosteroids or underlying host factors.
T216 3698-3858 Sentence denotes Nevertheless, the high rate of Aspergillus recovered from COVID-19 patients suggests that there might be conditions that favor growth of the fungus in the lung.
T217 3859-4112 Sentence denotes We think that the proposed IAPA case definitions may be considered for classification of CAPA patients, while awaiting further histopathological studies that provide more insight into the interaction between Aspergillus and the SARS-CoV-2-infected lung.
T218 4113-4172 Sentence denotes Table 2 Comparison between characteristics of IAPA and CAPA
T219 4173-4189 Sentence denotes Factor IAPA CAPA
T220 4190-4288 Sentence denotes Host/Risk 57% EORTC/MSGERC host factor negative [9] 85% EORTC/MSGERC host factor negative [59, 60]
T221 4289-4408 Sentence denotes IAPA associated with corticosteroid use [7] IPA developed in SARS-2003-infected patients receiving corticosteroids [61]
T222 4409-4511 Sentence denotes Lymphopenia and chemokine-producing monocyte-derived FCN1 + macrophages causing hyperinflammation [62]
T223 4512-4680 Sentence denotes Virus Cell entry through sialic acids-2,6Gal: epithelial layer in lung including larger airways [63] Cell entry through ACE2: type 2 pneumocytes and ciliated cells [64]
T224 4681-4883 Sentence denotes Immune modulation by suppression of the NADPH oxidase complex [65] No evidence for immunomodulatory effect on known antifungal host defense mechanisms, although this has not been extensively studied yet
T225 4884-5035 Sentence denotes Fungal infection Invasive Aspergillus tracheobronchitis in up to 55% of patients [7–9] Invasive Aspergillus tracheobronchitis not yet reported [59, 60]
T226 5036-5168 Sentence denotes Median time between ICU admission and IAPA diagnosis 2–3 days [7–9] Median time between ICU admission and CAPA diagnosis 6 days [59]
T227 5169-5299 Sentence denotes Aspergillus diagnostics BAL GM positive in > 88% [7–9] BAL GM commonly positive, diagnostic performance currently unknown [59, 60]
T228 5300-5392 Sentence denotes Serum GM positive in 65% [7–9] Serum GM positive in 3 of 14 (21%) COVID-19 patients [59, 60]
T229 5393-5592 Sentence denotes Secondary infections In 80 of 342 (23.4%) ICU patients, most frequent pathogens S. pneumoniae, Pseudomonas aeruginosa and S. aureus [66] In four of 13 (31%) ICU patients, pathogens not specified [67]
T230 5593-5914 Sentence denotes ICU mortality 45% in IAPA compared with 20% in influenza without IAPA (p < 0.0001) [9] 33% in CAPA cases compared with 17% in COVID-19 without CAPA (p = 0.4) [59] (although mortality rates due to COVID-19 without CAPA vary enormous between countries and we have no clear data yet on the true mortality in ICU of COVID-19)