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Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study

Title: Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study
Authors: Rouzé, Anahita; Lemaitre, Elise; Martin-Loeches, Ignacio; Povoa, Pedro; Diaz, Emili; Nyga, Rémy; Torres, Antoni; Metzelard, Matthieu; Du Cheyron, Damien; Lambiotte, Fabien; Tamion, Fabienne; Labruyere, Marie; Boulle Geronimi, Claire; Luyt, Charles-Edouard; Nyunga, Martine; Pouly, Olivier; Thille, Arnaud; Megarbane, Bruno; Saade, Anastasia; Magira, Eleni; Llitjos, Jean-François; Ioannidou, Iliana; Pierre, Alexandre; Reignier, Jean; Garot, Denis; Kreitmann, Louis; Baudel, Jean-Luc; Voiriot, Guillaume; Plantefeve, Gaëtan; Morawiec, Elise; Asfar, Pierre; Boyer, Alexandre; Mekontso-Dessap, Armand; Makris, Demosthenes; Vinsonneau, Christophe; Floch, Pierre-Edouard; Marois, Clémence; Ceccato, Adrian; Artigas, Antonio; Gaudet, Alexandre; Nora, David; Cornu, Marjorie; Duhamel, Alain; Labreuche, Julien; Nseir, Saad; Bouchereau, Mathilde; Sendid, Boualem; Boyd, Sean; Coelho, Luis; Maizel, Julien; Cuchet, Pierre; Zarrougui, Wafa; Boyer, Déborah; Quenot, Jean-Pierre; Imouloudene, Mehdi; de Chambrun, Marc Pineton; van der Linden, Thierry; Arrive, François; Voicu, Sebastian; Azoulay, Elie; Moglia, Edgard; Pene, Frédéric; Cilloniz, Catia; Thevenin, Didier; Larrat, Charlotte; Argaud, Laurent; Guidet, Bertrand; Turpin, Matthieu; Contou, Damien; Beurton, Alexandra; Demiselle, Julien; Meguerditchian, David; Razazi, Keyvan; Arrestier, Romain; Tsolaki, Vassiliki; Marzouk, Mehdi; Brunin, Guillaume; Weiss, Nicolas; Morales, Luis
Contributors: Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576; Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 RID-AGE; Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 UGSF
Publisher Information: BioMed Central
Publication Year: 2024
Collection: LillOA (Lille Open Archive - Université de Lille)
Description: 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 .
Document Type: other/unknown material
File Description: application/octet-stream
Language: English
Relation: Critical Care; http://hdl.handle.net/20.500.12210/107691
Availability: https://hdl.handle.net/20.500.12210/107691
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.9BCBE5B3
Database: BASE