Universität zu Köln

Giacobbe, Daniele Roberto ORCID: 0000-0003-2385-1759, Prattes, Juergen ORCID: 0000-0001-5751-9311, Wauters, Joost, Dettori, Silvia, Signori, Alessio, Salmanton-Garcia, Jon, Maertens, Johan, Bourgeois, Marc, Reynders, Marijke, Rutsaert, Lynn, Van Regenmortel, Niels, Lormans, Piet, Feys, Simon, Klimko, Nikolay, Shadrivova, Olga, Cornely, Oliver A. ORCID: 0000-0001-9599-3137, Rautemaa-Richardson, Riina, Koehler, Philipp, Lagrou, Katrien, Bassetti, Matteo and Hoenigl, Martin (2022). Prognostic Impact of Bronchoalveolar Lavage Fluid Galactomannan and Aspergillus Culture Results on Survival in COVID-19 Intensive Care Unit Patients: a Post Hoc Analysis from the European Confederation of Medical Mycology (ECMM) COVID-19-Associated Pulmonary Aspergillosis Study. J. Clin. Microbiol., 60 (4). WASHINGTON: AMER SOC MICROBIOLOGY. ISSN 1098-660X

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Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used as a survival proxy remains unknown. We conducted a post hoc analysis of a previous multicenter, multinational observational study with the aim of assessing the differential prognostic impact of BALF mycological tests, namely, positive (optical density index of >= 1.0) BALF galactomannan (GM) and positive BALF Aspergillus culture alone or in combination for critically ill patients with COVID-19. Of the 592 critically ill patients with COVID-19 enrolled in the main study, 218 were included in this post hoc analysis, as they had both test results available. CAPA was diagnosed in 56/218 patients (26%). Most cases were probable CAPA (51/56 [91%]) and fewer were proven CAPA (5/56 [9%]). In the final multivariable model adjusted for between-center heterogeneity, an independent association with 90-day mortality was observed for the combination of positive BALF GM and positive BALF Aspergillus culture in comparison with both tests negative (hazard ratio, 2.53; 95% CI confidence interval [CI], 1.28 to 5.02; P = 0.008). The other independent predictors of 90-day mortality were increasing age and active malignant disease. In conclusion, the combination of positive BALF GM and positive BALF Aspergillus culture was associated with increased 90-day mortality in critically ill patients with COVID-19. Additional study is needed to explore the possible prognostic value of other BALF markers. Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used as a survival proxy remains unknown.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Giacobbe, Daniele Roberto UNSPECIFIED orcid.org/0000-0003-2385-1759 UNSPECIFIED Prattes, Juergen UNSPECIFIED orcid.org/0000-0001-5751-9311 UNSPECIFIED Wauters, Joost UNSPECIFIED UNSPECIFIED UNSPECIFIED Dettori, Silvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Signori, Alessio UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertens, Johan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bourgeois, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Reynders, Marijke UNSPECIFIED UNSPECIFIED UNSPECIFIED Rutsaert, Lynn UNSPECIFIED UNSPECIFIED UNSPECIFIED Van Regenmortel, Niels UNSPECIFIED UNSPECIFIED UNSPECIFIED Lormans, Piet UNSPECIFIED UNSPECIFIED UNSPECIFIED Feys, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Klimko, Nikolay UNSPECIFIED UNSPECIFIED UNSPECIFIED Shadrivova, Olga UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED orcid.org/0000-0001-9599-3137 UNSPECIFIED Rautemaa-Richardson, Riina UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Lagrou, Katrien UNSPECIFIED UNSPECIFIED UNSPECIFIED Bassetti, Matteo UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-694184
DOI:	10.1128/jcm.02298-21
Journal or Publication Title:	J. Clin. Microbiol.
Volume:	60
Number:	4
Date:	2022
Publisher:	AMER SOC MICROBIOLOGY
Place of Publication:	WASHINGTON
ISSN:	1098-660X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69418