[HTML][HTML] Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance

P Koehler, M Bassetti, A Chakrabarti… - The Lancet Infectious …, 2021 - thelancet.com
P Koehler, M Bassetti, A Chakrabarti, SCA Chen, AL Colombo, M Hoenigl, N Klimko…
The Lancet Infectious Diseases, 2021thelancet.com
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 …
Summary
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.
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