The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study.

Publication date: Feb 03, 2024

Several criteria exist to diagnose pulmonary aspergillosis with varying degrees of certainty in specific populations, including oncohaematological patients (EORTC/MSG), ICU patients (mAspICU) and COVID-19 patients (ECMM). At the beginning of the pandemic, however, the diagnosis of COVID-19-Associated Pulmonary Aspergillosis (CAPA) could not be performed easily, and the decision to treat (DTT) was empirical. In this cross-sectional retrospective study including patients with SARS-CoV-2 infection and suspicion of CAPA, we studied the concordance between the DTT and the three diagnostic criteria using Cohen’s coefficient, and then we identified the factors associated with the DTT and corrected them by treatment to study the influence of the diagnostic criteria on survival. We showed good concordance of the DTT and mAspICU and ECMM criteria, with “compatible signs”, “positive culture” and “positive galactomannan” influencing the DTT. Treatment also showed a positive effect on survival once corrected for a putative, possible or probable diagnosis of CAPA using mAspICU and ECMM criteria. We conclude that EORTC/MSGERC are not considered applicable in clinical practice due to the lack of inclusion of signs and symptoms and do not lead to improved survival. mAspICU and ECMM criteria showed a good degree of agreement with the DTT and a positive correlation with patient recovery.

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Concepts Keywords
Antibiotics CAPA
Easily case definitions
Pandemic COVID-19
Pulmonary pulmonary aspergillosis
Retrospective

Semantics

Type Source Name
disease MESH COVID-19
disease MESH Pulmonary Aspergillosis
pathway REACTOME SARS-CoV-2 Infection
disease VO LACK
drug DRUGBANK Coenzyme M
disease MESH opportunistic infection
disease IDO entity
disease MESH aspergillosis
disease VO organization
disease MESH Cancer
disease MESH Invasive Fungal Infections
disease MESH Allergy
disease MESH Infectious Diseases
disease MESH Mycoses
disease IDO algorithm
disease MESH critically ill
disease IDO host
disease MESH neutropenia
disease IDO immunosuppression
disease MESH influenza
drug DRUGBANK Dimercaprol
disease VO population
disease MESH Death
disease VO frequency
drug DRUGBANK Medical air
disease MESH Obesity
disease VO protocol
disease MESH Infection
drug DRUGBANK L-Phenylalanine
drug DRUGBANK Tacrine
disease MESH Mucormycosis
disease MESH invasive pulmonary aspergillosis

Original Article

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