Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance.
Severe acute respiratory syndrome coronavirus 2 causes direct damage to the airway epithelium, enabling aspergillus invasion. Reports of COVID-19-associated pulmonary aspergillosis have raised concerns about it worsening the disease course of COVID-19 and increasing mortality. Additionally, the first cases of COVID-19-associated pulmonary aspergillosis caused by azole-resistant aspergillus have been reported. This article constitutes a consensus statement on defining and managing COVID-19-associated pulmonary aspergillosis, prepared by experts and endorsed by medical mycology societies. COVID-19-associated pulmonary aspergillosis is proposed to be defined as possible, probable, or proven on the basis of sample validity and thus diagnostic certainty. Recommended first-line therapy is either voriconazole or isavuconazole. If azole resistance is a concern, then liposomal amphotericin B is the drug of choice. Our aim is to provide definitions for clinical research and up-to-date recommendations for clinical management of the diagnosis and treatment of COVID-19-associated pulmonary aspergillosis.
Koehler, P; Bassetti, M; Chakrabarti, A; Chen, SCA; Colombo, AL; Hoenigl, M; Klimko, N; Lass-Flörl, C; Oladele, RO; Vinh, DC; Zhu, L-P; Böll, B; Brüggemann, R; Gangneux, J-P; Perfect, JR; Patterson, TF; Persigehl, T; Meis, JF; Ostrosky-Zeichner, L; White, PL; Verweij, PE; Cornely, OA; European Confederation of Medical Mycology, ; International Society for Human Animal Mycology, ; Asia Fungal Working Group, ; INFOCUS LATAM/ISHAM Working Group, ; ISHAM Pan Africa Mycology Working Group, ; European Society for Clinical Microbiology, ; Infectious Diseases Fungal Infection Study Group, ; ESCMID Study Group for Infections in Critically Ill Patients, ; Interregional Association of Clinical Microbiology and Antimicrobial Chemotherapy, ; Medical Mycology Society of Nigeria, ; Medical Mycology Society of China Medicine Education Association, ; Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology, ; Association of Medical Microbiology, ; Infectious Disease Canada,
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