Table IV.
Diagnostic evaluation and antifungal therapies of COVID-19-associated pulmonary aspergillosis (CAPA) patients
| Cultures |
Biomarkers |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Author | Positive LRTC (%) | LRTC Source (%) | Positive LRT PCR (%) | Aspergillus Spp. (%) | CAPA diagnostic criteria (%) | EORTC host risk factors (%) | Serum GM >0.5 ODI (%) | BAL GM >1.0 ODI (%) | Serum Beta-D-Glucan >80 pg/mL (%) | Antifungals |
| Alanio et al. [21] | 77.7 | BAL (100) | BAL (44.4) | A. fumigatus (100) | Putative CAPA (Modified AspICU-DB) | 22.2 | 11.1 | 11.1 | 44.4 | Voriconazole (11.1), caspofungin (11.1) |
| Bartoletti et al. [22] | 63.0 | BAL (100) | BAL (67.0) | A. fumigatus (78.9), A. niger (15.8), A. flavus (5.3) | Probable CAPA (IAPA) | 27.0 | 3.0 | 100 | NR | Voriconazole (43) |
| Chauvet et al. [26] | 66.7 | BAL (50), ETA (50). | ETA (16.7) | A. fumigatus (100) | Putative CAPA (83.3) [Modified AspICU-DB], Possible CAPA (16.7) [EORTC/MSG] | 33.3 | NR | NR | NR | Voriconazole (33.3); amphotericin B (33.3); caspofungin (16.7). |
| Delliere et al. [25] | 100 | BAL (76), ETA (24) | BAL/ETA (71.4) | A. spp. | Probable CAPA (IAPA) | 23.8 | 23.8 | 14.3 | 52.4 | NR |
| Dupont et al. [43] | 94.7 | BAL (44.4), BAS (33.3), ETA (22.2) | NR | A. fumigatus (87.5), A. flavus (6.3), A. calidoustus (6.3) | Putative CAPA (Modified AspICU-DB) | NR | 5.3 | 42.1 | NR | Voriconazole (47.4) |
| Gangneux et al. [15] | 85.7 | BAL/ETA (100) | BAL/ETA (100) | A. fumigatus (100) | Probable (42.9), putative (57.1) CAPA [Modified AspICU-G] | NR | 28.6 | NR | NR | Voriconazole/ isavuconazole (100) |
| Helleberg et al. [60] | 100 | ETA (100), BAL (50) | NR | A. fumigatus (100) | Putative CAPA (Modified AspICU-DB) | NR | 50.0 | 50.0 | NR | Voriconazole (100) |
| Koehler et al. [28] | 60.0 | BAL (75), ETA (25) | BAL (60), ETA (20) | A. fumigatus (100) | Putative CAPA (Modified AspICU-DB) | NR | 40.0 | 60.0 | NR | Voriconazole (100), caspofungin (40), isavuconazole (20) |
| Lahmer et al. [29] | 81.8 | BAL (100) | NR | A. fumigatus (100) | Probable CAPA (IAPA) | NR | 36.4 | 100 | NR | Voriconazole (45.4); amphotericin B (45.4); isavuconazole (9.1). |
| Lamoth et al. [42] | 100 | BAS (100) | BAS (33.3) | A. fumigatus (100) | Putative CAPA (Modified AspICU-DB) | NR | 33.3 | NR | 33.3 | Voriconazole (100) |
| Machado et al. [24] | 100 | BAL (100) | NR | A. fumigatus (66.6), A. citrinoterreus (16.7), A. lentulus (16.7) | Putative CAPA (Modified AspICU-DB) | 50.0 | 66.7 | 33.3 | NR | Isavuconazole (50), voriconazole (25), amphotericin B (25) |
| Meijer et al. [61] | 100 | BAL (61.5), ETA (38.5). | BAL (38.5), ETA (15.4). | A. fumigatus (100) | Probable (61.5), Possible (38.5) CAPA [CAPA-ECMM] | NR | NR | 15.4 | 7.7 | Voriconazole (100); amphotericin B (38.5); caspofungin (38.5). |
| Nasir et al. [19] | 100 | Sputum/ ETA/BAL (100) | NR | A. flavus (60), A. fumigatus (20), A. terreus (20) | Putative CAPA (Modified AspICU-DB) | NR | NR | NR | 20.0 | Voriconazole (33.3), amphotericin B (22.2) |
| Roman-Montes et al. [27] | 78.6 | ETA (100) | NR | A. fumigatus (54.5), A. spp. (27.3), A. flavus (9.1), A. niger (9.1) | Putative CAPA (Modified AspICU-DB) | NR | 42.9 | 85.7 (ETA) | NR | Voriconazole (83.3), echinocandin (15.3) |
| Rutsaert et al. [20] | 85.7 | BAL (83.3), ETA (16.7) | NR | A. fumigatus (83.3), A. flavus (16.7) | Putative CAPA (AspICU) | 42.9 | 14.3 | 57.1 | NR | Voriconazole (85.7), isavuconazole (28.6) |
| Van Arkel et al. [62] | 83.3 | BAL (40), ETA (40), Sputum (20) | NR | A. fumigatus (100) | Probable CAPA (IAPA) | NR | NR | 50.0 | NR | Voriconazole/ anidulafungin (83.3), amphotericin B (16.7) |
| Van Biesen et al. [23] | 77.7 | BAL (100) | NR | A. fumigatus (71.4), A. flavus (14.3), A. terreus (14.3) | Probable CAPA (IAPA) | 11.1 | NR | 100 | NR | Voriconazole/ amphotericin B (100) |
| Velez Pintado et al. [63] | 12.5 | BAL (100) | NR | A. spp. | Probable (CAPA- ECMM) | NR | 43.8 | 56.3 | NR | NR |
| Versyck et al. [64] | 100 | BAL (50), ETA (50). | NR | A. fumigatus (100) | Putative CAPA (Modified AspICU-DB) | NR | 100 | 50.0 | 100 | Voriconazole (100) |
A., Aspergillus; BAL, bronchoalveolar lavage; BAS, bronchial aspirates; ,ECMM, European Excellence Centre for Medical Mycology; EORTC/MSG, European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group; ETA, endotracheal aspirate; GM, galactomannan; IAPA, influenza-associated pulmonary aspergillosis (IAPA) criteria–Verweij et al.; LRT, lower respiratory tract.
LRTC, lower respiratory tract cultures; Modified AspICU DB, Modified AspICU–Dutch/Belgian Mycosis Study Group; Modified AspICU-G, Modified AspICU–Gangneux et al.; NR, non-reported/negative; ODI, optimal density index; PCR, polymerase chain reaction; Spp., species.