LitCovid-sentences  

PMC:7558333 / 14679-19833 JSONTXT 10 Projects

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Id Subject Object Predicate Lexical cue
T113 0-2 Sentence denotes 4.
T114 3-13 Sentence denotes Discussion
T115 14-237 Sentence denotes In France, the global burden of severe fungal infection is estimated at approximately 1,000,000 (1.47%) cases each year [13] and IFD account for a higher risk of mortality in patients with co-morbidities from 9 to 40% [14].
T116 238-411 Sentence denotes During the COVID-19 pandemic, warning messages considering similarities between Sars-CoV-2 and influenza infections stressed the importance of vigilance towards IFD [15,16].
T117 412-505 Sentence denotes Local experiences are now published and show high numbers of putative IA [17,18,19,20,21,22].
T118 506-671 Sentence denotes The diagnosis of IA still remains challenging because of a wide diversity of underlying conditions and growing number of criteria, particularly biological tools [6].
T119 672-965 Sentence denotes In deeply immunosuppressed patients, such as neutropenic patients, patients under antineoplastic and prolonged corticosteroid therapy or solid organ transplantation, criteria for classification of IFD and notably IA have recently been revised incorporating Aspergillus molecular detection [2].
T120 966-1135 Sentence denotes In ICU, the AspICU algorithm published by Blot et al., [3] is a robust and helpful tool for aspergillosis classification but needs to be more evaluated and even updated.
T121 1136-1389 Sentence denotes In order to address limitations of the various classification definitions for ICU patients, the ongoing FUNgal infections Definitions in ICU patients (FUNDICU) project aims to develop a standard set of definitions for IFD in critically ill patients [5].
T122 1390-1510 Sentence denotes The breaking news of SARS-CoV-2 co-infection urges the need for a critical analysis of the criteria of AspICU algorithm.
T123 1511-1986 Sentence denotes Indeed, COVID-19 patients, particularly ARDS patients with mechanical ventilation, present with compatible clinical signs as depicted by the algorithm (refractory fever, pleuritic chest pain and rub, dyspnea, hemoptysis and worsening respiratory insufficiency, see [3] for full description) and CT-scan signs are hard to interpret because of COVID-19 CT-scan presentation, leading to absence or very poor discrimination between Aspergillus colonization and infection [19,23].
T124 1987-2195 Sentence denotes As a result, IA during COVID-19 has been reported with a possible overestimated high prevalence (until 30%), as favorable outcomes have been described in patients who did not receive any antifungal treatment.
T125 2196-2547 Sentence denotes In order to have a well-balanced patient management, limiting unnecessary and costly antifungal treatments while not neglecting the life-threatening feature of IA, we included A. fumigatus PCR as a monitoring tool for fungal detection in both respiratory and blood samples in addition to classical culture and GM approaches but with some restrictions.
T126 2548-2628 Sentence denotes As expected, PCR allowed detecting Aspergillus in much more respiratory samples.
T127 2629-2788 Sentence denotes We previously showed that PCR improved the detection of Aspergillus in BAL, with a particular added value in ICU patients compared to hematology patients [11].
T128 2789-2940 Sentence denotes Furthermore, PCR using in-house but also marketed kits is also capable of identifying specific gene mutations associated with azole resistance [11,24].
T129 2941-3070 Sentence denotes Besides, the sensitivity of GM detection in blood is less sensitive in ICU than for patients with hematological malignancies [5].
T130 3071-3211 Sentence denotes Here, the higher sensitivity of Aspergillus detection also incites us to adopt modified criteria for case definition to gain in specificity.
T131 3212-3673 Sentence denotes Two major changes were introduced to modify the granularity of the classification: (i) the first one is to combine Aspergillus detection in respiratory samples and anti-Aspergillus antibody testing, to distinguish chronic colonization (positive serology) from acute massive colonization (negative serology) and (ii) the second is to introduce of obvious biomarkers of angioinvasion (serum GM and blood PCR), similar to those of the EORTC/MSG classification [2].
T132 3674-3918 Sentence denotes Of note, the combination of positive culture, positive anti-Aspergillus antibody testing and positive GM in the context of chronic respiratory diseases characterized a transition step from chronic pulmonary aspergillosis to probable IA [25,26].
T133 3919-4240 Sentence denotes Using this refined classification, we were able to categorize our patients in five classes: no infection, colonization, putative IA, probable IA and proven IA (no case of proven IA in the cohort), with a better relevance than the initial AspICU classification, and better specificity than the AspICU + PCR classification.
T134 4241-4412 Sentence denotes The decision of antifungal treatment onset was taken according to this modified AspICU classification and the outcome observed gives confidence in this patient management.
T135 4413-4603 Sentence denotes Of course, the limitation of this work is the relatively small number of patients and should be evaluated on larger cohorts in order to correctly analyze the performance of this alternative.
T136 4604-4775 Sentence denotes A remaining question is also to determine the place of the serum biomarker (1,3)-β-d-glucan in ICU patients, a question that has recently been raised by Honoré et al. [27]
T137 4776-4972 Sentence denotes In conclusion, molecular techniques are now key tools for monitoring IFD, particularly IA as recently updated in the EORTC/MSG definitions, but also Pneumocystis jirovecii or mucorales infections.
T138 4973-5079 Sentence denotes Here, we suggest some adaptations of the AspICU clinical algorithm to gain in sensitivity and specificity.
T139 5080-5154 Sentence denotes Large multicentric data are needed to confirm this proof of concept study.