Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e149-e162 |
| Journal | The Lancet Infectious Diseases |
| Volume | 21 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2021 |
ASJC Scopus subject areas
- Infectious Diseases
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Defining and managing COVID-19-associated pulmonary aspergillosis : the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. / the Medical Mycology Society of Nigeria; the Medical Mycology Society of China Medicine Education Association; Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology et al.
In: The Lancet Infectious Diseases, Vol. 21, No. 6, 06.2021, p. e149-e162.Research output: Contribution to journal › Review article › peer-review
}
TY - JOUR
T1 - Defining and managing COVID-19-associated pulmonary aspergillosis
T2 - the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance
AU - the Medical Mycology Society of Nigeria
AU - the Medical Mycology Society of China Medicine Education Association
AU - Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology
AU - Association of Medical Microbiology
AU - Infectious Disease Canada
AU - European Confederation of Medical Mycology
AU - the International Society for Human Animal Mycology
AU - the Asia Fungal Working Group
AU - the INFOCUS LATAM/ISHAM Working Group
AU - the ISHAM Pan Africa Mycology Working Group
AU - the European Society for Clinical Microbiology
AU - Infectious Diseases Fungal Infection Study Group
AU - the ESCMID Study Group for Infections in Critically Ill Patients
AU - the Interregional Association of Clinical Microbiology and Antimicrobial Chemotherapy
AU - Koehler, Philipp
AU - Bassetti, Matteo
AU - Chakrabarti, Arunaloke
AU - Chen, Sharon C.A.
AU - Colombo, Arnaldo Lopes
AU - Hoenigl, Martin
AU - Klimko, Nikolay
AU - Lass-Flörl, Cornelia
AU - Oladele, Rita O.
AU - Vinh, Donald C.
AU - Zhu, Li Ping
AU - Böll, Boris
AU - Brüggemann, Roger
AU - Gangneux, Jean Pierre
AU - Perfect, John R.
AU - Patterson, Thomas F.
AU - Persigehl, Thorsten
AU - Meis, Jacques F.
AU - Ostrosky-Zeichner, Luis
AU - White, P. Lewis
AU - Verweij, Paul E.
AU - Cornely, Oliver A.
N1 - Funding Information: PK has received non-financial scientific grants from Miltenyi Biotec and the Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases; and lecture honoraria from, or is advisor to, Akademie für Infektionsmedizin, Astellas Pharma, European Confederation of Medical Mycology, Gilead Sciences, Gesundheits- und Pflegezentrum Ruesselsheim Academy Ruesselsheim, Merck Sharp and Dohme, Noxxon, and University Hospital of Munich, outside the submitted work. MB has participated in advisory boards or received speaker honoraria from Achaogen, Angelini, Astellas, Bayer, Basilea, BioMeérieux, Cidara, Gilead Sciences, Menarini, Merck Sharp and Dohme, Nabriva, Paratek, Pfizer, Roche, Melinta, Shionogi, Tetraphase, VenatoRx, and Vifor; and has received study grants from Angelini, Basilea, Astellas, Shionogi, Cidara, Melinta, Gilead Sciences, Pfizer, and Merck Sharp and Dohme, outside the submitted work. SCAC has participated in advisory boards or received speaker honoraria from Merck Sharp and Dohme Australia and Gilead Sciences; and has received untied educational grants from Merck Sharp and Dohme Australia and grants from F2G, outside the submitted work. ALC reports grants from Pfizer and Astellas; personal fees from Pfizer, Astellas, and Gilead Sciences; and personal fees and non-financial support from Eurofarma, United Medical-Biotoscana, and Merck Sharp and Dohme, outside the submitted work. MH reports grants from Gilead Sciences and Pfizer, outside the submitted work. NK reports grants from Pfizer and personal fees from Astellas, Gilead Sciences, Merck Sharp and Dohme, and Pfizer, outside the submitted work. CL-F reports grants from Gilead Sciences and Astellas Pharma; personal fees from Gilead Sciences, Merck Sharp and Dohme, Basilea, and Angelini; and other from Gilead Sciences, Astellas Pharma, Merck Sharp and Dohme, and Basilea, outside the submitted work. ROO reports grants from Pfizer and Gilead Sciences, outside the submitted work. DCV is supported by the Fonds de la recherche en sante du Quebec clinician-scientist scholar program (Junior 2); has received research grants from Canadian Institutes of Health Research, CSL Behring Canada, La Fondation du Grand Défi Pierre Lavoie, and US Department of Defense; has received clinical trials funding from Cidara Therapeutics, CSL Behring, and Janssen Pharmaceuticals; and is an advisor to, or has received speaker honoraria from, CSL Behring, Novartis Canada, and UCB Biosciences. L-PZ reports grants from Merck Sharp and Dohme and Pfizer, outside the submitted work. BB reports personal fees from Baxalta, Celgene, Merck Sharp and Dohme, Mundipharma, Johnson and Johnson, Roche, and Takeda; and grants from Celgene, Merck Sharp and Dohme, Roche, Sanofi, Takeda, and AstraZeneca, outside the submitted work. RB has served as a consultant to Astellas Pharma, F2G, Amplyx, Gilead Sciences, Merck Sharp and Dohme, and Pfizer; and has received unrestricted and research grants from Astellas Pharma, Gilead Sciences, Merck Sharp and Dohme, and Pfizer, outside the submitted work, for which contracts were through Radboudumc and all payments were invoiced by Radboudumc. J-PG has participated in advisory boards or received speaker honoraria from Pfizer and Gilead Sciences, outside the submitted work. JRP reports grants from Merck Sharp and Dohme, Astellas, Pfizer, Amplyx, Ampili, and Minnetronix; and other from F2G, Scynexis, and Matinas, outside the submitted work. TFP reports grants to UT Health San Antonio from Cidara and F2G; and consulting fees from Basilea, Mayne, Merck, Pfizer, and Scynexis, outside the submitted work. JFM reports grants from F2G and Pulmocide; consultancy fees from Scynexis; and speaker fees from Gilead Sciences, United Medical, and TEVA, outside the submitted work. LO-Z reports grants from Gilead Sciences, Astellas, Pfizer, Cidara, Scynexis; and personal fees from Gilead Sciences, Astellas, Pfizer, Cidara, F2G, Viracor, and Stendhal, outside the submitted work. PLW reports speaker fees from Gilead Sciences, F2G, Merck Sharp and Dohme, and Pfizer; expert advice fees from Gilead Sciences and F2G; and meeting sponsorship from Bruker, Dynamiker, Launch Diagnostics, and Gilead Sciences. PLW did diagnostic evaluations for Bruker, Dynamiker, and Launch Diagnostics and is a founding member of the European Aspergillus PCR Initiative. PEV reports grants from Mundipharma, F2G, Pfizer, Thermofisher, Cidara, and Gilead Sciences; and non-financial support from IMMY, outside the submitted work. OAC is supported by the German Federal Ministry of Research and Education; is funded by the Deutsche Forschungsgemeinschaft under Germany's Excellence Strategy (CECAD, EXC 2030— 390661388); and has received research grants from, is an advisor to, or received lecture honoraria from Actelion, Allecra Therapeutics, Al-Jazeera Pharmaceuticals, Amplyx, Astellas, Basilea, Biosys, Cidara, Da Volterra, Entasis, F2G, Gilead Sceinces, Grupo Biotoscana, IQVIA, Janssen, Matinas, Medicines Company, MedPace, Melinta Therapeutics, Menarini, Merck Sharp and Dohme, Mylan, Nabriva, Noxxon, Octapharma, Paratek, Pfizer, PSI, Roche Diagnostics, Scynexis, and Shionogi. AC and TP declare no competing interests. Publisher Copyright: © 2021 Elsevier Ltd
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85099207213&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099207213&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(20)30847-1
DO - 10.1016/S1473-3099(20)30847-1
M3 - Review article
C2 - 33333012
AN - SCOPUS:85099207213
SN - 1473-3099
VL - 21
SP - e149-e162
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 6
ER -