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Estella Á, Recuerda Núñez M, Lagares C, Gracia Romero M, Torres E, Alados Arboledas JC, Antón Escors Á, González García C, Sandar Núñez D, López Prieto D, Sánchez Calvo JM. Anticipatory Antifungal Treatment in Critically Ill Patients with SARS-CoV-2 Pneumonia. J Fungi (Basel) 2023; 9:jof9030288. [PMID: 36983456 PMCID: PMC10056030 DOI: 10.3390/jof9030288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
: Background. The aim of this study was to investigate the incidence of COVID-19-associated pulmonary aspergillosis (CAPA) in critically ill patients and the impact of anticipatory antifungal treatment on the incidence of CAPA in critically ill patients. Methods. Before/after observational study in a mixed intensive care unit (ICU) of a university teaching hospital. The study took place between March 2020 and June 2022. Inclusion criteria were critically ill patients with severe SARS-CoV-2 pneumonia requiring invasive mechanical ventilation. Two analysis periods were compared according to whether or not antifungal therapy was given early. Results. A total of 160 patients with severe SARS-CoV-2 pneumonia and invasive mechanical ventilation were included. The incidence of CAPA in the first study period was 19 out of 58 patients (32.75%); during the second period, after implementation of the intervention (anticipatory antifungal therapy), the incidence of CAPA decreased to 10.78% (11 out of 102 patients). In patients with CAPA under invasive mechanical ventilation, the mortality rate decreased from 100% to 64%. Conclusions. Anticipating antifungal treatment in patients with SARS-CoV-2 pneumonia under invasive mechanical ventilation was associated with a decrease in the incidence and mortality of pulmonary aspergillosis.
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Affiliation(s)
- Ángel Estella
- Intensive Care Unit, Medicine Department, University of Cádiz, University Hospital of Jerez, INIBiCA, 11407 Jerez, Spain
- Correspondence: (Á.E.); (M.R.N.); Tel.: +34-956-032090 (Á.E.)
| | - María Recuerda Núñez
- Intensive Care Unit, Medicine Department, University of Cádiz, University Hospital of Jerez, INIBiCA, 11407 Jerez, Spain
- Correspondence: (Á.E.); (M.R.N.); Tel.: +34-956-032090 (Á.E.)
| | - Carolina Lagares
- Department of Statistical and Operational Research, PAIDI Group CTS553, University of Cádiz, 11510 Cádiz, Spain
| | - Manuel Gracia Romero
- Intensive Care Unit, Medicine Department, University of Cádiz, University Hospital of Jerez, INIBiCA, 11407 Jerez, Spain
| | - Eva Torres
- Microbiology Department, University Hospital of Jerez, 11407 Jerez, Spain
| | | | | | | | - Dolores Sandar Núñez
- Intensive Care Unit, Medicine Department, University of Cádiz, University Hospital of Jerez, INIBiCA, 11407 Jerez, Spain
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