Practice Guidelines for the Diagnosis of COVID-19-Associated Pulmonary Aspergillosis in an Intensive Care Setting.

{"article_title":"Practice Guidelines for the Diagnosis of COVID-19-Associated Pulmonary Aspergillosis in an Intensive Care Setting.","author":"Hashim Z, Neyaz Z, Marak RSK, Nath A, Nityanand S, Tripathy NK","journal_title":"Journal of intensive care medicine","issn":"1525-1489","isbn":"","publication_date":"2022 Aug","volume":"37","issue":"8","first_page":"985","page_count":"","accession_number":"34678103","doi":"10.1177\/08850666211047166","publisher":"Sage Publications","doctype":"Journal Article","subjects":"COVID-19 complications; Pulmonary Aspergillosis diagnosis; Respiratory Distress Syndrome; COVID-19 Testing; Critical Care; Humans; Pandemics","interest_area":["Infectious Disease & Vaccines"," Pulmonology"," Emergency Medicine"],"abstract":"Coronavirus disease-2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a new disease characterized by secondary Aspergillus mold infection in patients with COVID-19. It primarily affects patients with COVID-19 in critical state with acute respiratory distress syndrome, requiring intensive care and mechanical ventilation. CAPA has a higher mortality rate than COVID-19, posing a serious threat to affected individuals. COVID-19 is a potential risk factor for CAPA and has already claimed a massive death toll worldwide since its outbreak in December 2019. Its second wave is currently progressing towards a peak, while the third wave of this devastating pandemic is expected to follow. Therefore, an early and accurate diagnosis of CAPA is of utmost importance for effective clinical management of this highly fatal disease. However, there are no uniform criteria for diagnosing CAPA in an intensive care setting. Therefore, based on a review of existing information and our own experience, we have proposed new criteria in the form of practice guidelines for diagnosing CAPA, focusing on the points relevant for intensivists and pulmonary and critical care physicians. The main highlights of these guidelines include the role of CAPA-appropriate test specimens, clinical risk factors, computed tomography of the thorax, and non-culture-based indirect and direct mycological evidence for diagnosing CAPA in the intensive care unit. These guidelines classify the diagnosis of CAPA into suspected, possible, and probable categories to facilitate clinical decision-making. We hope that these practice guidelines will adequately address the diagnostic challenges of CAPA, providing an easy-to-use and practical algorithm to clinicians for rapid diagnosis and clinical management of the disease.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=34678103&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Hashim Z, Neyaz Z, Marak RSK, Nath A, Nityanand S, Tripathy NK","Journal_Info":"Publisher: Sage Publications Country of Publication: United States NLM ID: 8610344 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1489 (Electronic) Linking ISSN: 08850666 NLM ISO Abbreviation: J Intensive Care Med Subsets: MEDLINE","Publication_Type":"Journal Article; Review","Published_Date":"2022-08-01","Source":"Journal of intensive care medicine [J Intensive Care Med] 2022 Aug; Vol. 37 (8), pp. 985-997. Date of Electronic Publication: 2021 Oct 22.","Languages":"English","Electronic_ISSN":"1525-1489","MeSH_Terms":"COVID-19*\/complications , Pulmonary Aspergillosis*\/diagnosis , Respiratory Distress Syndrome*, COVID-19 Testing ; Critical Care ; Humans ; Pandemics","Subjects":"COVID-19 Testing, Critical Care, Humans, Pandemics, COVID-19 complications, Pulmonary Aspergillosis diagnosis, Respiratory Distress Syndrome","Title_Abbreviations":"Journal of intensive care medicine","Volume":"37"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"34678103","RelevancyScore":"889","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"888.654357910156"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34678103&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34678103&authtype=shib&custid=ns346513&group=main&profile=eds"}