Title
Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study
Date Issued
01 December 2022
Access level
metadata only access
Resource Type
journal article
Author(s)
Rouzé A.
Lemaitre E.
Martin-Loeches I.
Povoa P.
Diaz E.
Nyga R.
Torres A.
Metzelard M.
Du Cheyron D.
Lambiotte F.
Tamion F.
Labruyere M.
Boulle Geronimi C.
Luyt C.E.
Nyunga M.
Pouly O.
Thille A.W.
Megarbane B.
Saade A.
Magira E.
Llitjos J.F.
Ioannidou I.
Pierre A.
Reignier J.
Garot D.
Kreitmann L.
Baudel J.L.
Voiriot G.
Plantefeve G.
Morawiec E.
Asfar P.
Boyer A.
Mekontso-Dessap A.
Makris D.
Vinsonneau C.
Floch P.E.
Marois C.
Ceccato A.
Artigas A.
Gaudet A.
Nora D.
Cornu M.
Duhamel A.
Labreuche J.
Nseir S.
Bouchereau M.
Sendid B.
Boyd S.
Coelho L.
Maizel J.
Cuchet P.
Zarrougui W.
Boyer D.
Quenot J.P.
Imouloudene M.
de Chambrun M.P.
Van Der Linden T.
Arrive F.
Voicu S.
Azoulay E.
Moglia E.
Pene F.
Thevenin D.
Larrat C.
Argaud L.
Guidet B.
Turpin M.
Contou D.
Beurton A.
Demiselle J.
Meguerditchian D.
Razazi K.
Arrestier R.
Tsolaki V.
Marzouk M.
Brunin G.
Weiss N.
Morales L.
University of Barcelona
Publisher(s)
BioMed Central Ltd
Abstract
Background: Recent multicenter studies identified COVID-19 as a risk factor for invasive pulmonary aspergillosis (IPA). However, no large multicenter study has compared the incidence of IPA between COVID-19 and influenza patients. Objectives: To determine the incidence of putative IPA in critically ill SARS-CoV-2 patients, compared with influenza patients. Methods: This study was a planned ancillary analysis of the coVAPid multicenter retrospective European cohort. Consecutive adult patients requiring invasive mechanical ventilation for > 48 h for SARS-CoV-2 pneumonia or influenza pneumonia were included. The 28-day cumulative incidence of putative IPA, based on Blot definition, was the primary outcome. IPA incidence was estimated using the Kalbfleisch and Prentice method, considering extubation (dead or alive) within 28 days as competing event. Results: A total of 1047 patients were included (566 in the SARS-CoV-2 group and 481 in the influenza group). The incidence of putative IPA was lower in SARS-CoV-2 pneumonia group (14, 2.5%) than in influenza pneumonia group (29, 6%), adjusted cause-specific hazard ratio (cHR) 3.29 (95% CI 1.53–7.02, p = 0.0006). When putative IPA and Aspergillus respiratory tract colonization were combined, the incidence was also significantly lower in the SARS-CoV-2 group, as compared to influenza group (4.1% vs. 10.2%), adjusted cHR 3.21 (95% CI 1.88–5.46, p < 0.0001). In the whole study population, putative IPA was associated with significant increase in 28-day mortality rate, and length of ICU stay, compared with colonized patients, or those with no IPA or Aspergillus colonization. Conclusions: Overall, the incidence of putative IPA was low. Its incidence was significantly lower in patients with SARS-CoV-2 pneumonia than in those with influenza pneumonia. Clinical trial registration The study was registered at ClinicalTrials.gov, number NCT04359693.
Volume
26
Issue
1
Language
English
OCDE Knowledge area
Epidemiología
Scopus EID
2-s2.0-85122459229
PubMed ID
Source
Critical Care
ISSN of the container
13648535
Sponsor(s)
AR received personal fees from Maat Pharma, IML received personal fees from MSD, and Gilead. AA received personal fees from Lilly Foundation, and grants from Grifols and Fisher & Paykel. CEL received personal fees from Bayer, Merck, Aerogen, Biomérieux, ThermoFisher Brahms, and Carmat. SN received personal fees from MSD, Bio-Rad, BioMérieux, Gilead, Fisher and Paykel, and Pfizer. All other authors declare no competing interests. This study was supported in part by a grant from the French government through the « Programme Investissement d’Avenir» (I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). Prof. Ignacio Martin-Loeches has been supported by SFI (Science Foundation Ireland), Grant Number 20/COV/0038. The funders of the study had no role in the study design, data collection, analysis, or interpretation, writing of the report, or decision to submit for publication.
Sources of information: Directorio de Producción Científica Scopus