Asperges, E.; Pesare, R.; Bassoli, C.; Calia, M.; Lerta, S.; Citiolo, F.; Albi, G.; Cavanna, C.; Sacchi, P.; Bruno, R. The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study. Antibiotics2024, 13, 150.
Asperges, E.; Pesare, R.; Bassoli, C.; Calia, M.; Lerta, S.; Citiolo, F.; Albi, G.; Cavanna, C.; Sacchi, P.; Bruno, R. The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study. Antibiotics 2024, 13, 150.
Asperges, E.; Pesare, R.; Bassoli, C.; Calia, M.; Lerta, S.; Citiolo, F.; Albi, G.; Cavanna, C.; Sacchi, P.; Bruno, R. The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study. Antibiotics2024, 13, 150.
Asperges, E.; Pesare, R.; Bassoli, C.; Calia, M.; Lerta, S.; Citiolo, F.; Albi, G.; Cavanna, C.; Sacchi, P.; Bruno, R. The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study. Antibiotics 2024, 13, 150.
Abstract
Several criteria exist to diagnose pulmonary aspergillosis with varying degrees of certainty in specific populations, including oncohaematological patients (EORTC/MSG), ICU patients (AspICU) and Covid-19 patients (ECMM). At the beginning of the pandemic, however, the diagnosis of Covid-19 Associated Pulmonary Aspergillosis (CAPA) could not be performed easily, and the decision to treat (DTT) was empirical. In this cross-sectional retrospective study including patients with SARS-CoV-2 infection and a suspicion of CAPA, we studied the concordance between the DTT and the three diagnostic criteria using Cohen’s coefficient, then we identified the factors associated with the DTT and we corrected by treatment to study the influence of the diagnostic criteria on survival. We showed good concordance of DTT and AspICU and ECMM criteria, with “compatible signs”, “positive culture” and “positive galattomannan” influencing the DTT. Treatment also showed a positive effect on survival once corrected for a putative, possible or probable diagnosis of CAPA using AspICU and ECMM criteria. We conclude that EORTC/MSGERC are not considered applicable in clinical practice due to lack of inclusion of signs and symptoms and do not lead to improved survival. AspICU and ECMM criteria showed a good degree of agreement with the DTT and a positive correlation with patient recovery.
Keywords
COVID-19; pulmonary aspergillosis; case definitions; CAPA; certain/probable/possible diagnosis
Subject
Medicine and Pharmacology, Epidemiology and Infectious Diseases
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
