Coronavirus Disease 2019 (COVID-19)-associated pulmonary aspergillosis is an emerging entity. We report two fatal cases of putative COVID-19-associated pulmonary aspergillosis. Both cases were diagnosed on the basis of respiratory tract cultures yielding Aspergillus species and otherwise unexplained clinical and radiological deterioration. Existing published literature on COVID-19-associated pulmonary aspergillosis indicate poor outcomes and high mortality. CAPA should be considered in patients with critical COVID-19 who have unexplained progressive respiratory failure despite optimized supportive care. Diagnostic work-up should be initiated as early as possible and should ideally include fungal cultures, galactomannan detection and Aspergillus PCR on tracheal aspirates or broncho-alveolar lavage fluid. Empiric systemic antifungal therapy may be justified in selected cases, pending diagnostic work up results. Large, multi-center studies are required to further understand the pathogenesis of invasive aspergillosis in COVID-19, and the optimal diagnostic and treatment strategies.
【저자키워드】 COVID-19, ICU, Viral pneumonia, aspergillosis, 【초록키워드】 Pathogenesis, diagnostic, outcome, Deterioration, PCR, Culture, Patient, respiratory tract, Aspergillus, Critical, fungal, supportive care, Treatment strategies, high mortality, cultures, progressive respiratory failure, invasive, antifungal therapy, radiological, selected, include, diagnosed, required, initiated, tracheal aspirate, yielding, 【제목키워드】 review, pulmonary, literature, report,