In this study published in J. Clinic. Microbiol. this month, Sarah Dellière and colleagues from the Alanio’s group at the Molecular Mycology team assess 7 mycological criteria with the aim of improving the diagnosis of COVID19-associated pulmonary aspergillosis (CAPA). Reports on COVID19–associated aspergillosis (CAPA) are increasing. However, incidence, diagnosis and management remain unclear. Because both the imaging and clinical criteria as defined by the European Confederation for Medical Mycology and International Society for Human and Animal Mycology (ECMM/ISHAM) are very frequent in COVID19 patients, it is essential to evaluate the mycological criterion that will be used to diagnose CAPA.
The criteria assessed in this study ranged from direct examination and culture of respiratory samples to qPCR to detect the presence or absence of Aspergillus fumigatus in samples.
Using a retrospective cohort of 176 COVID19 patients who received mechanical ventilation, the researchers show that a combination of markers and/or blood biomarkers and/or direct respiratory sample examination seems more likely to identify patients with CAPA. In addition, Af–qPCR may help identifying false positive results of BAL galactomannan testing and culture on respiratory samples while quantifying fungal burden accurately.