https://nottingham-repository.worktribe.com/preview/4517059/J%20Infection_14%20May.pdf

Co-infections in people with COVID-19: a systematic review and meta-analysis.

http://diposit.ub.edu/dspace/bitstream/2445/171648/1/704106.pdf

Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study.

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.

/pdf/defining-and-managing-covid-19-associated-pulmonary-2nkyydr117.pdf

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

Objectives Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates coronavirus disease 19 (COVID-19) associated invasive aspergillosis at a single centre in Cologne, Germany. Methods A retrospective chart review of all patients with COVID-19 associated ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Cologne, Germany. Results COVID-19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS. Conclusion Clinicians caring for patients with ARDS due to COVID-19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co-infection.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/myc.13096

COVID-19 associated pulmonary aspergillosis.

Bacterial and fungal coinfection among hospitalized patients with COVID-19: a retrospective cohort study in a UK secondary-care setting.

Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study.

Context . Acute intoxications are frequently seen in Dutch hospitals. Based on single-centre studies and the fact that there are no clear guidelines, we hypothesised that hospital admission of acute intoxications may vary. Furthermore, decontamination treatment of poisonings may differ between hospitals, as earlier studies showed that adherence to international guidelines concerning decontamination may be poor. Objective . We aim to identify possible variations in Dutch hospital admission and decontamination treatment of patients with acute intoxications. Materials and methods . Data on acute intoxications was retrospectively collected from patient records from the emergency departments of six Dutch hospitals. All patients older than 14 years who presented between 1 January 2008 and 31 December 2008 were included in the study. Results . The percentage of suicide attempts differed signifi cantly between the hospitals (25 – 73%, p 0.0001) as equally the percentage of intoxications with drugs of abuse (18 – 61%, p 0.0001). Marked differences in admission rates were found (27 – 78%, p 0.0001) and these differences remained even when intoxications because of suicide attempts and drugs of abuse were analysed separately (admission rate of 52 – 87%, p 0.0001 and 8 – 71%, p 0.0001 respectively). Reported consultation with the National Poisons Information Centre differed between hospitals (range 0% to 80 – 100%). No statistical differences were found between hospitals for the use of activated charcoal (16.1 – 42.5%, p = 0.037). Gastric lavage was used infrequently in all hospitals. (6.6 – 16.7%, p = 0.614). Discussion and conclusion . The admission rate of patients with an acute intoxication varies considerably, especially in the case of intoxications with drugs of abuse. Consultations with the National Poisons Information Centre differed between the six hospitals. Rates of decontamination did not vary, which may indicate adherence to guidelines by the American Academy of Clinical Toxicology, European Association of Poisons Centres and Clinical Toxicologists. National guidelines or admission algorithms may reduce variations in poisoning management and make the care for these patients more effi cient.

Astrid Hoedemaekers

Papers

Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study.

Acute intoxications: Differences in management between six Dutch hospitals

TH-104. Reliable prediction of poor outcome in postanoxic coma using EEG in a four-electrode frontotemporal montage