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

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Title

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

Description

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.

Date

2020-12-14

Citation

Koehler, Philipp, Matteo Bassetti, Arunaloke Chakrabarti, Sharon C. A. Chen, Arnaldo Lopes Colombo, Martin Hoenigl, Nikolay Klimko, Cornelia Lass-Flörl, Rita O. Oladele, Donald C. Vinh, Li-Ping Zhu, Boris Böll, Roger Brüggemann, Jean-Pierre Gangneux, John R. Perfect, Thomas F. Patterson, Thorsten Persigehl, Jacques F. Meis, Luis Ostrosky-Zeichner, P. Lewis White, Paul E. Verweij, and Oliver A. Cornely. 2020. "Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance." The Lancet Infectious Diseases.

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.

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Free online on Lancet site.

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