TABLE 1.
Main Characteristics of the Coronavirus Disease 2019 Acute Respiratory Distress Syndrome Patients With Documented Coronavirus Disease 2019-Associated Pulmonary Aspergillosis
| Patient | 1 | 2 | 3 | 4 | 5 | 6 |
|---|---|---|---|---|---|---|
| Age (yr), gender | 54, male | 68, male | 70, male | 76, male | 63, male | 68, male |
| Medical history | AF, COPD, HT, OSAS, pulmonary HT, transient ischemic attack, congenital heart disease, and end-stage renal disease | Myeloperoxidase-antineutrophil cytoplasm antibodies associated vasculitis, chronic kidney disease, and nephrectomy | Junctional tachycardia, bipolar disorder, and HT | COPD, type 2 diabetes, hypercholesterolemia, hypothyroidism, and HT | AF, obesity, OSAS, and gastric ulcer | Atherosclerosis, AF, sarcopenia, and COPD |
| Immunosuppression | Heart and kidney transplantation | Immunsuppressive drugs for vasculitis | No | No | No | No |
| Admission Pao2/Fio2 ratio (Berlin definition of ARDS) | 218 (mild) | 120 (moderate) | 76 (severe) | 48 (severe) | 78 (severe) | 128 (moderate) |
| Worst Sepsis-Related Organ Failure Assessment score | 18 | 17 | 11 | 12 | 18 | 16 |
| Steroids | Prednisone 10 mg/d (prior to admission) | Prednisone 5 mg/d (prior to admission) | Dexamethasone 20 mg/d (ARDS treatment) | Nasal mometasone furoate (prior to admission) and dexamethasone 20 mg/d (ARDS treatment) | No | Dexamethasone 20 mg/d (ARDS treatment) |
| Fungal culture | BAL: Aspergillus fumigatus | TA: A. fumigatus | — | — | BAL: A. fumigatus | TA: A fumigatus |
| Bronchoalveolar lavage fluid galactomannan > 1 | Positive | Not performed | Positive | Not performed | Not performed | Negative |
| Polymerase chain reaction Aspergillus | Not performed | TA: A. fumigatus | Not performed | Not performed | Not performed | Not performed |
| Invasive pulmonary aspergillosis definition | Asp-ICU algorithm: putative | Asp-ICU algorithm: putative | modified Asp-ICU algorithm: putative | European Organization for Research and Treatment of Cancer Mycoses Study Grouppossible | modified Asp-ICU algorithm: putative | Asp-ICU algorithm: putative |
| Delay after ICU admission (d) | 6 | 14 | 32 | 9 | 3 | 6 |
| Treatment | Lip. Ampho. B | Lip. Ampho. B | Caspofugin | — | Voriconazole and isavuconazole | Voriconazole |
| Outcome | Alive | Died | Died | Died | Died | Alive |
| Hospital stay if alive | > 60 d | — | — | — | — | > 60 d |
AF = atrial fibrillation, ARDS = acute respiratory distress syndrome, Asp-ICU = diagnosis algorithm for aspergillosis in ICU, BAL = bronchoalveolar lavage, COPD = chronic obstructive pulmonary disease, HT = hypertension, Lip. Ampho. B = liposomal amphotericin B, OSAS = obstructive sleep apnea syndrome, TA = tracheal aspirates.