Determinants of poor clinical outcome in patients with influenza pneumonia: A systematic review and meta-analysis

Arranz-Herrero, Javier; Presa, Jesús; Ríus-Rocabert, Sergio; Utrero‐Rico, Alberto; Arranz-Arija, José Ángel; Lalueza, Antonio; Escribese, María M.; Ochando, Jordi; Soriano, Vincent; Nistal-Villan, Estanislao

doi:10.1016/j.ijid.2023.04.003

Cited by 9 publications

(2 citation statements)

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“…Patients with viral pneumonia are at high risk of bacterial and fungal coinfections and superinfections 1–3 . Respiratory viruses have the capacity to damage the alveolar epithelium and endothelial respiratory barrier 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Patients with viral pneumonia are at high risk of bacterial and fungal coinfections and superinfections. [1][2][3] Respiratory viruses have the capacity to damage the alveolar epithelium and endothelial respiratory barrier. 4 In influenza-associated pulmonary aspergillosis (IAPA), the respiratory damage caused by influenza in critically ill patients enables this fungal infection.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, bacterial coinfections and outcomes in COVID‐19‐associated pulmonary aspergillosis in a third‐level Mexican hospital during the COVID‐19 pre‐vaccination era

Hernández‐Silva,

Corzo‐León,

Becerril‐Vargas

et al. 2024

Mycoses

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BackgroundDamage due to respiratory viruses increases the risk of bacterial and fungal coinfections and superinfections. High rates of invasive aspergillosis are seen in severe influenza and COVID‐19. This report describes CAPA cases diagnosed during the first wave in the biggest reference centre for severe COVID‐19 in Mexico.ObjectivesTo describe the clinical, microbiological and radiological characteristics of patients with invasive pulmonary aspergillosis associated with critical COVID‐19, as well as to describe the variables associated with mortality.MethodsThis retrospective study identified CAPA cases among individuals with COVID‐19 and ARDS, hospitalised from 1 March 2020 to 31 March 2021. CAPA was defined according to ECMM/ISHAM consensus criteria. Prevalence was estimated. Clinical and microbiological characteristics including bacterial superinfections, antifungal susceptibility testing and outcomes were documented.ResultsPossible CAPA was diagnosed in 86 patients among 2080 individuals with severe COVID‐19, representing 4.13% prevalence. All CAPA cases had a positive respiratory culture for Aspergillus species. Aspergillus fumigatus was the most frequent isolate (64%, n = 55/86). Seven isolates (9%, n = 7/80) were resistant to amphotericin B (A. fumigatus n = 5/55, 9%; A. niger, n = 2/7, 28%), two A. fumigatus isolates were resistant to itraconazole (3.6%, n = 2/55). Tracheal galactomannan values ranged between 1.2 and 4.05, while serum galactomannan was positive only in 11% (n = 3/26). Bacterial coinfection were documented in 46% (n = 40/86). Gram negatives were the most frequent cause (77%, n = 31/40 isolates), from which 13% (n = 4/31) were reported as multidrug‐resistant bacteria. Mortality rate was 60% and worse prognosis was seen in older persons, high tracheal galactomannan index and high HbA1c level.ConclusionsOne in 10 individuals with CAPA carry a resistant Aspergillus isolate and/or will be affected by a MDR bacteria. High mortality rates are seen in this population.

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Section: Introductionmentioning

confidence: 99%