Tendency in Pulmonary Aspergillosis Investigation during the COVID-19 Era: What Is Changing?

Int J Environ Res Public Health. 2022 Jun 9;19(12):7079. doi: 10.3390/ijerph19127079.

Abstract

Aspergillosis is a disease caused by Aspergillus, and invasive pulmonary aspergillosis (IPA) is the most common invasive fungal infection leading to death in severely immuno-compromised patients. The literature reports Aspergillus co-infections in patients with COVID-19 (CAPA). Diagnosing CAPA clinically is complex since the symptoms are non-specific, and performing a bronchoscopy is difficult. Generally, the microbiological diagnosis of aspergillosis is based on cultural methods and on searching for the circulating antigens galactomannan and 1,3-β-D-glucan in the bronchoalveolar lavage fluid (bGM) or serum (sGM). In this study, to verify whether the COVID-19 period has stimulated clinicians to pay greater attention to IPA in patients with respiratory tract infections, we evaluated the number of requests for GM-Ag research and the number of positive tests found during the pre-COVID-19 and COVID-19 periods. Our data show a significant upward trend in GM-Ag requests and positivity from the pre-COVID to COVID period, which is attributable in particular to the increase in IPA risk factors as a complication of COVID-19. In the COVID period, parallel to the increase in requests, the number of positive tests for GM-Ag also increased, going from 2.5% in the first period of 2020 to 12.3% in the first period of 2021.

Keywords: 1,3-β-D-glucan; CAPA; aspergillosis; galactomannan; invasive pulmonary aspergillosis.

MeSH terms

  • Aspergillus
  • Bronchoalveolar Lavage Fluid
  • COVID-19* / epidemiology
  • Humans
  • Invasive Pulmonary Aspergillosis* / complications
  • Invasive Pulmonary Aspergillosis* / diagnosis
  • Invasive Pulmonary Aspergillosis* / epidemiology
  • Pulmonary Aspergillosis* / complications
  • Pulmonary Aspergillosis* / diagnosis
  • Pulmonary Aspergillosis* / epidemiology
  • Sensitivity and Specificity

Grants and funding

This research received no external funding.