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
  • , Association of Medical Microbiology
  • , Infectious Disease Canada
  • , European Confederation of Medical Mycology
  • , the International Society for Human Animal Mycology
  • , the Asia Fungal Working Group
  • , the INFOCUS LATAM/ISHAM Working Group
  • , the ISHAM Pan Africa Mycology Working Group
  • , the European Society for Clinical Microbiology
  • , Infectious Diseases Fungal Infection Study Group
  • , the ESCMID Study Group for Infections in Critically Ill Patients
  • , the Interregional Association of Clinical Microbiology and Antimicrobial Chemotherapy

Research output: Contribution to journalReview articlepeer-review

749 Scopus citations

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 languageEnglish (US)
Pages (from-to)e149-e162
JournalThe Lancet Infectious Diseases
Volume21
Issue number6
DOIs
StatePublished - Jun 2021

ASJC Scopus subject areas

  • Infectious Diseases

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