Diagnostic dilemma in COVID-19-associated pulmonary aspergillosis

The largest series of CAPA cases include data from four low-income and middle-income countries (LMICs).4 In these and other LMICs, very few clinical laboratories do fungal PCR or expensive serology-based tests such as galactomannan and β-D-glucan. At our institute from July to December, 2020, 490 tr...

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Bibliographic Details
Published in:	The Lancet infectious diseases 2021-06, Vol.21 (6), p.767-767
Main Authors:	Jabeen, Kauser, Farooqi, Joveria, Irfan, Muhammad, Ali, Syed Ahsan, Denning, David W
Format:	Article
Language:	eng
Subjects:	Antigens Aspergillosis Aspergillus Clinical microbiology Coronaviruses Correspondence COVID-19 COVID-19 - complications COVID-19 - diagnosis Glucan Guidelines Humans Income Infectious diseases Laboratories Microbiology Pharmaceuticals Pulmonary Aspergillosis - complications Pulmonary Aspergillosis - diagnosis SARS-CoV-2 Serology
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Summary:	The largest series of CAPA cases include data from four low-income and middle-income countries (LMICs).4 In these and other LMICs, very few clinical laboratories do fungal PCR or expensive serology-based tests such as galactomannan and β-D-glucan. At our institute from July to December, 2020, 490 tracheal aspirates were sent for culture, compared with only two bronchial lavage samples from COVID-19 patients. [...]despite having substantial CAPA burden in our centre, none of the patients in retrospect could be categorised into any of the three grades of proven, probable, or possible, as suggested by Philipp Koehler and colleagues.1 A very restricted disease categorisation is concerning as it will lead to underrecognition of this important complication in patients with COVID-19, not only for surveillance but also for their management. DWD reports holding founder shares in F2G; acting as a consultant to Pulmatrix, Pulmocide, Zambon, iCo Therapeutics, Mayne Pharma, Biosergen, Bright Angel Therapeutics, Cipla, and Metis; being paid for talks on behalf of Dynamiker, Hikma, Gilead, Merck, Mylan, and Pfizer; and being a longstanding member of the Infectious Diseases Society of America Aspergillosis Guidelines group, the European Society for Clinical Microbiology, and Infectious Diseases Aspergillosis Guidelines group.
ISSN:	1473-3099 1474-4457