COVID-19 und Pilzinfektionen - Inzidenz - infektiologie.co.at
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COVID-19 und Pilzinfektionen – Inzidenz Professor Oliver A. Cornely MD, FECMM, FIDSA, FAAM, FACP Director and Chair, Translational Research & Clinical Trials Center University of Cologne Consultant, Infectious Diseases Director, European Mycology Excellence Center University Hospital of Cologne
Potentielle Interessenskonflikte
Forschungsmittel Actelion, Amplyx, Astellas, Basilea, Cidara, Da Volterra, F2G, Gilead,
Janssen, Medicines Company, Melinta, Merck/MSD, Octapharma, Pfizer,
Scynexis
Beratung zu Studiendesign, Actelion, Allecra, Amplyx, Astellas, Basilea, Biosys, Cidara, Da Volterra,
DRC oder DSMB Entasis, F2G, Gilead, Matinas, MedPace, Menarini, Merck/MSD, Mylan,
Nabriva, Noxxon, Octapharma, Paratek, Pfizer, PSI, Roche Diagnostics,
Scynexis, Shionogi
Vortragshonorare Al-Jazeera Pharmaceuticals, Astellas, Basilea, Gilead, Grupo Biotoscana,
Merck/MSD, Pfizer
EXC 2030 –390661388
Definitions
EORTC/MSG criteria Limitations Blot et al. algorithm Limitations
- Histopathology - Influenza
- Long-term immunosuppression - Culture
Proven Proven
Probable - CT scan Putative - Host factor?
Possible Colonizations
Not classifiable
- Serum GM (non-neutropenic) Not classifiable - ICU?
Verweij et al. consensus
definition
Limitations Koehler et al. consensus
definition Limitations
- BAL - BAL
- Serum GM (non-neutropenic) - NBL?
Proven
Proven
Probable
- Specific combination of imaging procedure Probable - ICU?
Possible
Not classifiable and mycological evidence Not classifiable
- ICU?
Salmanton-Garcia J et al. Mycology Week 2020 – Universidad de Antioquia. Donnelly JP et al. CID 2019; Blot S et al. AJRCCM 2012; Verweij P
et al. ICM 2020; Koehler et al. - under review.
Series and Incidence Rates
Patients with
Country COVID-19 patients ICU patients
mechanical ventilation
Belgium1 - - 4/34 11.8% 4/20 20.0%
- - 7/221 3.2% - -
China2,3
8/104 7.7% - - - -
- - - - 8/27 29.6%
France4,5
- - - - 9/45 20.0%
Germany6 - - 5/19 26.3% - -
Italy7 31/822 3.8% - - - -
Netherlands8 1/135 0.7% - - 1/31 3.2%
Pakistan9 9/147 6.1 % 9/23 39.1% - -
Switzerland10 - - 3/118 2.5% 3/80 3.8%
- - 0.7% - 7.7% - 2.5% - 39.1% - 3.2% - 29.6%
Rutsaert L et al. AnnIntCare 2020; Zhang G et al. JCV 2020; Wang J et al. Crit Care 2020; Alanio A et al. Lancet Respir Med 2020; Gangneux JP
et al. J Fungi 2020; Koehler P et al. Mycoses 2020; Bartoletti M et al. CID 2020; van Arkel ALE et al. AJRCCM 2020; Nasir J et al. Mycoses 2020;
Lamoth F et al. CMI 2020. Salmanton-Garcia J et al. Mycology Week 2020 – Universidad de Antioquia.
Distribution
?
? ?
?
?
?
Salmanton-Garcia J et al. Mycology Week 2020 – Universidad de Antioquia.
Risk Factors Compared to IAPA
IAPA vs. CAPA
ICU 100.0% ≈ 98.5%
Mechanical ventilation 90.0% ≈ 85.9%
Corticosteroid administration 56.0% ≈ 46.7%
Renal failure 42.0% ≈ 31.1%
Obesity 30.0% ≈ 23.0%
Chronic pulmonary disease 16.0% ≈ 20.0%
Hematological/Oncological malignancies 30.0% > 8.9%
Solid organ transplantation 13.0% > 2.2%
Diabetes mellitus 12.0% < 34.8%
Chronic cardiovascular disease - < 49.6%
Schauwvlieghe AFAD et al. Lancet Respir Med 2018. Salmanton-Garcia J et al. Mycology Week 2020 – Universidad de Antioquia.
Defining and Managing COVID-19 Associated Pulmonary Aspergillosis:
The 2020 ECMM/ISHAM Consensus Criteria for Research and Clinical Guidance
Philipp Koehler MD, Matteo Bassetti MD, Arunaloke Chakrabarti MD, Sharon C.A. Chen MD, Arnaldo Lopes Colombo MD, Martin Hoenigl MD, Nikolay Klimko MD, Cornelia
Lass Flörl MD, Rita O. Oladele MD, Donald C. Vinh MD, Li-Ping Zhu MD, Boris Böll MD, Roger Brüggemann PhD, Jean-Pierre Gangneux MD, John R. Perfect MD, Thomas F.
Patterson MD, Thorsten Persigehl MD, Jacques F. Meis MD PhD, Luis Ostrosky-Zeichner MD, P. Lewis White PhD, Paul E. Verweij MD PhD, and Oliver A. Cornely MD
ISHAM Pan Africa Mycology working group
The Medical Mycology Society of China Medicine Education Association (MMSCMEA)
The Medical Mycology Society of Nigeria (MMSN)
Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)
AMMI Canada
Seite 7 ECCVID | September 2020 | Philipp Köhler
Koehler et al. 2020. Manuscript under review.
CAPA Management Pocket Card Koehler P et al. DOI: 10.4126/FRL01-006421494 2020.
Bronchoscopy: A Crumbling Cornerstone in CAPA Koehler et al. Mycoses 2020. doi.org/10.1111/myc.13183.
COVID-Associated Invasive Candidiasis – CAIC
Posteraro B et al. J Fungi 2020. Chowdhary A et al. EID 2020.COVID-Associated Mucosal Candidiasis – CAMC
Salehi M et al. Mycoses 2020.COVID-Associated Mucormycosis
Werthman-Ehrenreich A. Am J Emerg Med 2020.Infectious Diseases In Motion
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