Imperial College London
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DrAnandShah

Faculty of Medicine, School of Public Health

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

s.anand

 
 
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Location

 

Fulham RoadRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Armstrong-James:2020:10.1183/13993003.02554-2020,
author = {Armstrong-James, D and Youngs, J and Bicanic, T and Abdolrasouli, A and Denning, DW and Johnson, E and Mehra, V and Pagliuca, T and Patel, B and Rhodes, J and Schelenz, S and Shah, A and van, de Veerdonk FL and Verweij, PE and White, PL and Fisher, MC},
doi = {10.1183/13993003.02554-2020},
journal = {European Respiratory Journal},
pages = {1--10},
title = {Confronting and mitigating the risk of COVID-19 Associated Pulmonary Aspergillosis (CAPA)},
url = {http://dx.doi.org/10.1183/13993003.02554-2020},
volume = {56},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Cases of COVID-19 associated pulmonary aspergillosis (CAPA) are being increasingly reported and physicians treating patients with COVID-19-related lung disease need to actively consider these fungal co-infections.The SARS-CoV-2 (COVID-19) virus causes a wide spectrum of disease in healthy individuals as well as those with common comorbidities [1]. Severe COVID-19 is characterised acute respiratory distress syndrome (ARDS) secondary to viral pneumonitis, treatment of which may require mechanical ventilation or extracorporeal membrane oxygenation (ECMO) [2]. Clinicians are alert to the possibility of bacterial co-infection as a complication of lower respiratory tract viral infection; for example a recent review found that 72% of patients with COVID-19 received antimicrobial therapy [3]. However, the risk of fungal co-infection, in particular COVID-19 associated pulmonary aspergillosis (CAPA), remains underappreciated.Fungal disease consistent with invasive aspergillosis (IA) has been observed with other severe Coronaviruses such as Severe Acute Respiratory Syndrome (SARS-CoV-2003) [4, 5] and Middle East Respiratory Syndrome (MERS-CoV) [6]. From the outset of the COVID-19 pandemic, there were warning signs of secondary invasive fungal infection; Aspergillus flavus was isolated from the respiratory tract from one of 99 patients in the first COVID-19 cohort from Wuhan to be reported in any detail [2] and Aspergillus spp. were isolated from 2/52 (3.8%) of a subsequent cohort of critically unwell patients from this region [7]. More recently, retrospective case series from Belgium [8], France [9], The Netherlands [10] and Germany [11] have reported evidence of CAPA in an alarming 20–35% of mechanically ventilated patients.
AU  - Armstrong-James,D
AU  - Youngs,J
AU  - Bicanic,T
AU  - Abdolrasouli,A
AU  - Denning,DW
AU  - Johnson,E
AU  - Mehra,V
AU  - Pagliuca,T
AU  - Patel,B
AU  - Rhodes,J
AU  - Schelenz,S
AU  - Shah,A
AU  - van,de Veerdonk FL
AU  - Verweij,PE
AU  - White,PL
AU  - Fisher,MC
DO  - 10.1183/13993003.02554-2020
EP  - 10
PY  - 2020///
SN  - 0903-1936
SP  - 1
TI  - Confronting and mitigating the risk of COVID-19 Associated Pulmonary Aspergillosis (CAPA)
T2  - European Respiratory Journal
UR  - http://dx.doi.org/10.1183/13993003.02554-2020
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32703771
UR  - https://erj.ersjournals.com/content/56/4/2002554.article-info
UR  - http://hdl.handle.net/10044/1/81083
VL  - 56
ER  -
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