Prevalence of co-existent COVID-19-associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID-19-associated pulmonary mucormycosis (CAPM)

被引：3

作者：

Muthu, Valliappan ^{[2
]}

Agarwal, Ritesh ^{[1
,2
]}

Rudramurthy, Shivaprakash Mandya ^{[2
]}

Thangaraju, Deepak ^{[3
]}

Shevkani, Manoj Radhakishan ^{[4
]}

Patel, Atul K. ^{[5
]}

Shastri, Prakash Srinivas ^{[6
]}

Tayade, Ashwini ^{[7
]}

Bhandari, Sudhir ^{[8
]}

Gella, Vishwanath ^{[9
]}

Savio, Jayanthi ^{[10
]}

Madan, Surabhi ^{[11
]}

Hallur, Vinaykumar ^{[12
]}

Maturu, Venkata Nagarjuna ^{[13
]}

Srinivasan, Arjun ^{[14
]}

Sethuraman, Nandini ^{[15
]}

Sibia, Raminder Pal Singh ^{[16
]}

Pujari, Sanjay ^{[17
]}

Mehta, Ravindra ^{[18
]}

Singhal, Tanu ^{[19
]}

Saxena, Puneet ^{[20
]}

Gupta, Varsha ^{[21
]}

Nagvekar, Vasant ^{[22
]}

Prayag, Parikshit ^{[23
]}

Patel, Dharmesh ^{[24
,25
]}

Xess, Immaculata ^{[26
]}

Savaj, Pratik ^{[27
]}

Sehgal, Inderpaul Singh ^{[2
]}

Panda, Naresh ^{[2
]}

Rajagopal, Gayathri Devi ^{[3
]}

Parwani, Riya Sandeep ^{[4
]}

Patel, Kamlesh ^{[5
]}

Deshmukh, Anuradha ^{[7
]}

Vyas, Aruna ^{[8
]}

Gandra, Raghava Rao ^{[9
]}

Sistla, Srinivas Kishore ^{[9
]}

Padaki, Priyadarshini A. ^{[10
]}

Ramar, Dharshni ^{[11
]}

Panigrahi, Manoj Kumar ^{[12
]}

Sarkar, Saurav ^{[12
]}

Rachagulla, Bharani ^{[13
]}

Vallandaramam, Pattabhiraman ^{[14
]}

Premachandran, Krishna Prabha ^{[15
]}

Pawar, Sunil ^{[16
]}

Gugale, Piyush ^{[17
]}

Hosamani, Pradeep ^{[18
]}

Dutt, Sunil Narayan ^{[18
]}

Nair, Satish ^{[18
]}

Kalpakkam, Hariprasad ^{[18
]}

Badhwar, Sanjiv ^{[19
]}

机构：

[1] Postgrad Inst Med Educ & Res, Dept Pulm Med, Sect 12, Chandigarh 160012, India

[2] Postgrad Inst Med Educ & Res, Chandigarh, India

[3] Kovai Med Ctr & Hosp, Coimbatore, India

[4] Avron Hosp, Ahmadabad, India

[5] Sterling Hosp, Ahmadabad, India

[6] Sir Gangaram Hosp, New Delhi, India

[7] Kingsway Hosp, Nagpur, Maharashtra, India

[8] Sawai Man Singh Med Coll, Jaipur, Rajasthan, India

[9] Asian Inst Gastroenterol, Hyderabad, Telangana, India

[10] St Johns Med Coll & Hosp, Bangalore, Karnataka, India

[11] Care Inst Med Sci, Ahmadabad, Gujarat, India

[12] All India Inst Med Sci, Bhubaneswar, Odisha, India

[13] Yashoda Hosp, Hyderabad, India

[14] Royal Care Hosp, Coimbatore, India

[15] Apollo Hosp, Chennai, India

[16] Govt Med Coll, Patiala, Punjab, India

[17] Poona Hosp & Res Ctr, Pune, Maharashtra, India

[18] Apollo Hosp, Bengaluru, Karnataka, India

[19] Kokilaben Dhirubhai Ambani Hosp & Med Res Inst, Mumbai, India

[20] Army Hosp Res & Referral, New Delhi, India

[21] Govt Med Coll, Chandigarh, India

[22] Global Hosp, Mumbai, India

[23] Deenanath Mangeshkar Hosp, Pune, India

[24] City Clin, Vadodara, Gujarat, India

[25] Bhailal Amin Gen Hosp, Vadodara, Gujarat, India

[26] All India Inst Med Sci, New Delhi, India

[27] Inst Infect Dis & Crit Care Hosp, Surat, Gujarat, India

来源：

MYCOSES | 2024年 / 67卷 / 05期

关键词：

aspergillus; corona virus; mixed mould infections; moulds; Rhizopus; zygomycosis; LOWER-RESPIRATORY-TRACT;

D O I：

10.1111/myc.13745

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Background: Data on mixed mould infection with COVID-19-associated pulmonary aspergillosis (CAPA) and COVID-19-associated pulmonary mucormycosis (CAPM) are sparse. Objectives: To ascertain the prevalence of co-existent CAPA in CAPM (mixed mould infection) and whether mixed mould infection is associated with early mortality (<= 7 days of diagnosis). Methods: We retrospectively analysed the data collected from 25 centres across India on COVID-19-associated mucormycosis. We included only CAPM and excluded subjects with disseminated or rhino-orbital mucormycosis. We defined co-existent CAPA if a respiratory specimen showed septate hyphae on smear, histopathology or culture grew Aspergillus spp. We also compare the demography, predisposing factors, severity of COVID-19, and management of CAPM patients with and without CAPA. Using a case-control design, we assess whether mixed mould infection (primary exposure) were associated with early mortality in CAPM. Results: We included 105 patients with CAPM. The prevalence of mixed mould infection was 20% (21/105). Patients with mixed mould infection experienced early mortality (9/21 [42.9%] vs. 15/84 [17.9%]; p = 0.02) and poorer survival at 6 weeks (7/21 [33.3] vs. 46/77 [59.7%]; p = 0.03) than CAPM alone. On imaging, consolidation was more commonly encountered with mixed mould infections than CAPM. Co-existent CAPA (odds ratio [95% confidence interval], 19.1 [2.62-139.1]) was independently associated with early mortality in CAPM after adjusting for hypoxemia during COVID-19 and other factors. Conclusion: Coinfection of CAPA and CAPM was not uncommon in our CAPM patients and portends a worse prognosis. Prospective studies from different countries are required to know the impact of mixed mould infection.

引用

页数：9

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