COVID-19 associated pulmonary aspergillosis in critically-ill patients: a prospective multicenter study in the era of Delta and Omicron variants - Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 Accéder directement au contenu
Article Dans Une Revue Annals of Intensive Care Année : 2024

COVID-19 associated pulmonary aspergillosis in critically-ill patients: a prospective multicenter study in the era of Delta and Omicron variants

1 CARMAS - Groupe de recherche clinique CARMAS (Cardiovascular and Respiratory Manifestations of Acute lung injury and Sepsis)
2 U955 Inserm - UPEC - IMRB - VHC/"Viruses-Hepatology-Cancers" [Créteil]
3 Hôpital Henri Mondor
4 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
5 Epidémiologie des maladies chroniques : impact des interactions gène environnement sur la santé des populations
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
8 Hôpital Ambroise Paré [AP-HP]
9 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
10 CESP - Centre de recherche en épidémiologie et santé des populations
11 Hôpital Paul Brousse
12 CRSA - Centre de Recherche Saint-Antoine
13 CHU Tenon [AP-HP]
14 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
15 CHU Saint-Antoine [AP-HP]
16 Centre hospitalier Marc Jacquet (Melun)
17 Centre Hospitalier Victor Dupouy
18 AP-HP - Hopital Saint-Louis [AP-HP]
19 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
20 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
21 Hôpital Louis Mourier - AP-HP [Colombes]
22 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
23 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
24 Hôpital Saint-Camille [Bry-sur-Marne]
25 CHU Pitié-Salpêtrière [AP-HP]
26 SU - Sorbonne Université
27 MFP - Microbiologie Fondamentale et Pathogénicité
28 CHU de Bordeaux - Centre Hospitalier Universitaire de Bordeaux
29 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
30 Cardiovascular & Renal Clinical Trialists - CRCT - French-Clinical Research Infrastructure Network - F-CRIN [Paris]
31 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
32 Service de Virologie [CHRU Nancy]
33 Hôpital Cochin [AP-HP]
34 Hôpital Avicenne [AP-HP]
35 CEPR - Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100
36 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
37 MAVIVHe - Morphogénèse et antigénicité du VIH, des Virus des Hépatites et Emergents
38 CNR VIH - Centre National de Référence du VIH [Tours] - laboratoire associé
39 CHU Rouen
40 DYNAMICURE - Dynamique Microbienne associée aux Infections Urinaires et Respiratoires
41 RESINFIT - Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
42 CIC1435 - Centre d'Investigation Clinique de Limoges
43 CNR Herpèsvirus - Centre National de Référence des Herpèsvirus [Limoges]
44 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
45 Irset - Institut de recherche en santé, environnement et travail
46 CHU Louise Michel [Clermont-Ferrand]
47 Service d'immunologie clinique et maladies infectieuses [Hôpitaux universitaires CHU Henri Mondor]
Elyanne Gault
  • Fonction : Auteur
  • PersonId : 900497
Damien Contou
  • Fonction : Auteur
  • PersonId : 1042428
Amandine Henry
Adrien Joseph
  • Fonction : Auteur
  • PersonId : 1090136
Cédric Hartard
Frédéric Pene
Flore Rozenberg
  • Fonction : Auteur
  • PersonId : 1121945
Stephane Gaudry
Segolene Brichler
Fabienne Tamion
Bertrand Souweine
  • Fonction : Auteur
  • PersonId : 942585
Cécile Henquell
Françoise Botterel

Résumé

BACKGROUND: During the first COVID-19 pandemic wave, COVID-19-associated pulmonary aspergillosis (CAPA) has been reported in up to 11-28% of critically ill COVID-19 patients and associated with increased mortality. As new SARS-CoV-2 variants emerged, the characteristics of critically ill COVID-19 patients have evolved, particularly in the era of Omicron. The purpose of this study is to investigate the characteristics of CAPA in the era of new variants. METHODS: This is a prospective multicenter observational cohort study conducted in France in 36 participating intensive care units (ICU), between December 7th, 2021 and April 26th 2023. Diagnosis criteria of CAPA relied on European Confederation of Medical Mycology (ECMM)/International Society for Human and Animal Mycology (ISHAM) consensus criteria. RESULTS: 566 patients were included over the study period. The prevalence of CAPA was 5.1% [95% CI 3.4-7.3], and rose to 9.1% among patients who required invasive mechanical ventilation (IMV). Univariable analysis showed that CAPA patients were more frequently immunosuppressed and required more frequently IMV support, vasopressors and renal replacement therapy during ICU stay than non-CAPA patients. SAPS II score at ICU admission, immunosuppression, and a SARS-CoV-2 Delta variant were independently associated with CAPA in multivariable logistic regression analysis. Although CAPA was not significantly associated with day-28 mortality, patients with CAPA experienced a longer duration of mechanical ventilation and ICU stay. CONCLUSION: This study contributes valuable insights into the prevalence, characteristics, and outcomes of CAPA in the era of Delta and Omicron variants. We report a lower prevalence of CAPA (5.1%) among critically-ill COVID-19 patients than previously reported, mainly affecting intubated-patients. Duration of mechanical ventilation and ICU stay were significantly longer in CAPA patients.
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hal-04577615 , version 1 (16-05-2024)

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Pierre Bay, Étienne Audureau, Sébastien Préau, Raphael Favory, Aurélie Guigon, et al.. COVID-19 associated pulmonary aspergillosis in critically-ill patients: a prospective multicenter study in the era of Delta and Omicron variants. Annals of Intensive Care, 2024, 14 (1), pp.65. ⟨10.1186/s13613-024-01296-0⟩. ⟨hal-04577615⟩
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