Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance

the Medical Mycology Society of Nigeria, the Medical Mycology Society of China Medicine Education Association, Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology, Association of Medical Microbiology, Infectious Disease Canada, European Confederation of Medical Mycology, the International Society for Human Animal Mycology, the Asia Fungal Working Group, the INFOCUS LATAM/ISHAM Working Group, the ISHAM Pan Africa Mycology Working Group, the European Society for Clinical Microbiology, Infectious Diseases Fungal Infection Study Group, the ESCMID Study Group for Infections in Critically Ill Patients, the Interregional Association of Clinical Microbiology and Antimicrobial Chemotherapy

Research output: Contribution to journalReview articlepeer-review

625 Citations (Scopus)

Abstract

Severe acute respiratory syndrome coronavirus 2 causes direct damage to the airway epithelium, enabling aspergillus invasion. Reports of COVID-19-associated pulmonary aspergillosis have raised concerns about it worsening the disease course of COVID-19 and increasing mortality. Additionally, the first cases of COVID-19-associated pulmonary aspergillosis caused by azole-resistant aspergillus have been reported. This article constitutes a consensus statement on defining and managing COVID-19-associated pulmonary aspergillosis, prepared by experts and endorsed by medical mycology societies. COVID-19-associated pulmonary aspergillosis is proposed to be defined as possible, probable, or proven on the basis of sample validity and thus diagnostic certainty. Recommended first-line therapy is either voriconazole or isavuconazole. If azole resistance is a concern, then liposomal amphotericin B is the drug of choice. Our aim is to provide definitions for clinical research and up-to-date recommendations for clinical management of the diagnosis and treatment of COVID-19-associated pulmonary aspergillosis.

Original languageEnglish
Pages (from-to)e149-e162
JournalThe Lancet Infectious Diseases
Volume21
Issue number6
DOIs
Publication statusPublished - Jun 2021
Externally publishedYes

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