engleski

Aspergillus co-infection in COVID-19 patients on invasive mechanical ventilation

Invasive aspergillosis is a well-known complication in patients with severe viral pneumonia and is associated with poorer prognosis and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes damage to the airway epithelium, enabling aspergillus invasion. The risk of fungal infections is further increased by the use of immunosuppressive drugs. We investigated the incidence of Aspergillus co- infection in patients with PCR-proven SARS-CoV-2 infection who required invasive mechanical ventilation (IMV). In the period from February 21 to November 23, 2021, a total of 73 patients were mechanically ventilated. In all of them, bronchial aspirate and bronchoalveolar lavage were cultured for fungi once a week. Aspergillus species was isolated in 11 patients (15%), 7 women (64%) and 4 men (36%). Among the isolates of the Aspergillus species, Aspergillus fumigatus was the most commonly detected (81.8%). However, in all respiratory samples positive for Aspergillus fumigatus, mixed fungal infection with either Aspergillus niger (1 patient, 11%), Aspergillus flavus (2 patients, 22%), Candida species (6 patients, 67%) or Trichosporon spp. (1 patient, 11%) was detected. The median age of patients was 70 years (range 46 to 80). In 64% of patients co- infections with Aspergillus occurred within 5 days of onset of IMV. The most common comorbidities were arterial hypertension (73%), chronic renal failure (36%) and diabetes mellitus (27%). In this study, we would like to highlight the importance of Aspergillus coinfection in critically ill COVID-19 patients. We believe that an early detection allows for timely treatment and better outcomes.

Aspergillus co-infection ; COVID 19

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