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      COVID-19 associated pulmonary aspergillosis (CAPA): An Australian case report

      case-report

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          Abstract

          As the COVID-19 pandemic has developed, concern for invasive fungal infections in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) has emerged. We describe a clinical case of coronavirus disease (COVID-19) associated pulmonary aspergillus (CAPA) infection and acute respiratory distress syndrome (ARDS) with a good clinical outcome, in a previously well, non-immunocompromised Australian woman.

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Fei Zhou, Ting Yu, Ronghui Du … (2020)
          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR

            Victor M Corman, Olfert Landt, Marco Kaiser … (2020)
            Background The ongoing outbreak of the recently emerged novel coronavirus (2019-nCoV) poses a challenge for public health laboratories as virus isolates are unavailable while there is growing evidence that the outbreak is more widespread than initially thought, and international spread through travellers does already occur. Aim We aimed to develop and deploy robust diagnostic methodology for use in public health laboratory settings without having virus material available. Methods Here we present a validated diagnostic workflow for 2019-nCoV, its design relying on close genetic relatedness of 2019-nCoV with SARS coronavirus, making use of synthetic nucleic acid technology. Results The workflow reliably detects 2019-nCoV, and further discriminates 2019-nCoV from SARS-CoV. Through coordination between academic and public laboratories, we confirmed assay exclusivity based on 297 original clinical specimens containing a full spectrum of human respiratory viruses. Control material is made available through European Virus Archive – Global (EVAg), a European Union infrastructure project. Conclusion The present study demonstrates the enormous response capacity achieved through coordination of academic and public laboratories in national and European research networks.
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              Clinical and immunologic features in severe and moderate Coronavirus Disease 2019

              Guang Chen, Di Wu, Wei. Guo … (2020)
              Journal of Clinical Investigation
              Article 0 comments Cited 2432 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Deepak Bhonagiri
                Journal
                Journal ID (nlm-ta): Med Mycol Case Rep
                Journal ID (iso-abbrev): Med Mycol Case Rep
                Title: Medical Mycology Case Reports
                Publisher: The Author(s). Published by Elsevier B.V. on behalf of International Society for Human and Animal Mycology.
                ISSN (Electronic): 2211-7539
                Publication date PMC-release: 18 June 2020
                Publication date (Electronic): 18 June 2020
                Affiliations
                [a ]Intensive Care Unit, Liverpool Hospital, NSW, Australia
                [b ]Department of Microbiology and Infectious Diseases, Liverpool Hospital, NSW, Australia
                [c ]Department of Respiratory and Sleep Medicine, Liverpool Hospital, NSW, Australia
                [d ]Department of Radiology, Liverpool Hospital, NSW, Australia
                Author notes
                Article
                Publisher ID: S2211-7539(20)30039-7
                DOI: 10.1016/j.mmcr.2020.06.002
                PMC ID: 7301813
                PubMed ID: 32837878
                SO-VID: 3a35c8b5-682f-432f-bd8b-8038a3b31e8a
                Copyright © © 2020 The Author(s). Published by Elsevier B.V. on behalf of International Society for Human and Animal Mycology.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 3 June 2020
                Date revision received : 9 June 2020
                Date accepted : 9 June 2020
                Categories
                Subject: Article

                Keywords: covid-19 associated pulmonary aspergillosis (capa),ards,icu,fungal infection
                Data availability:
                Keywords: covid-19 associated pulmonary aspergillosis (capa), ards, icu, fungal infection

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