Utilize este identificador para referenciar este registo:
https://hdl.handle.net/1822/65814
Título: | COVID-19 Associated Pulmonary Aspergillosis (CAPA)—From immunology to treatment |
Autor(es): | Arastehfar, Amir Carvalho, Agostinho van de Veerdonk, Frank L. Jenks, Jeffrey D. Koehler, Philipp Krause, Robert Cornely, Oliver A. S. Perlin, David Lass-Flörl, Cornelia Hoenigl, Martin |
Palavras-chave: | SARS-COV-2 Aspergillus novel coronavirus superinfection co-infection risk factors prevalence challenges immune response expert statement European Confederation of Medical Mycology COVID-19 |
Data: | 24-Jun-2020 |
Editora: | Multidisciplinary Digital Publishing Institute |
Revista: | Journal of Fungi |
Citação: | Arastehfar, A.; Carvalho, A.; van de Veerdonk, F.L.; Jenks, J.D.; Koehler, P.; Krause, R.; Cornely, O.A.; S. Perlin, D.; Lass-Flörl, C.; Hoenigl, M., on behalf of the ECMM Working Group Immunologic Markers for Treatment Monitoring and Diagnosis in Invasive Mold Infection; COVID-19 Associated Pulmonary Aspergillosis (CAPA)—From Immunology to Treatment. J. Fungi 2020, 6, 91. |
Resumo(s): | Like severe influenza, coronavirus disease-19 (COVID-19) resulting in acute respiratory distress syndrome (ARDS) has emerged as an important disease that predisposes patients to secondary pulmonary aspergillosis, with 35 cases of COVID-19 associated pulmonary aspergillosis (CAPA) published until June 2020. The release of danger-associated molecular patterns during severe COVID-19 results in both pulmonary epithelial damage and inflammatory disease, which are predisposing risk factors for pulmonary aspergillosis. Moreover, collateral effects of host recognition pathways required for the activation of antiviral immunity may, paradoxically, contribute to a highly permissive inflammatory environment that favors fungal pathogenesis. Diagnosis of CAPA remains challenging, mainly because bronchoalveolar lavage fluid galactomannan testing and culture, which represent the most sensitive diagnostic tests for aspergillosis in the ICU, are hindered by the fact that bronchoscopies are rarely performed in COVID-19 patients due to the risk of disease transmission. Similarly, autopsies are rarely performed, which may result in an underestimation of the prevalence of CAPA. Finally, the treatment of CAPA is complicated by drug–drug interactions associated with broad spectrum azoles, renal tropism and damage caused by SARS-CoV-2, which may challenge the use of liposomal amphotericin B, as well as the emergence of azole-resistance. This clinical reality creates an urgency for new antifungal drugs currently in advanced clinical development with more promising pharmacokinetic and pharmacodynamic profiles. |
Tipo: | Artigo |
URI: | https://hdl.handle.net/1822/65814 |
DOI: | 10.3390/jof6020091 |
e-ISSN: | 2309-608X |
Versão da editora: | https://www.mdpi.com/2309-608X/6/2/91 |
Arbitragem científica: | yes |
Acesso: | Acesso aberto |
Aparece nas coleções: | ICVS - Artigos em revistas internacionais / Papers in international journals |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
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jof-06-00091.pdf | 339,33 kB | Adobe PDF | Ver/Abrir |
Este trabalho está licenciado sob uma Licença Creative Commons