Defining and Managing COVID-19-associated Pulmonary Aspergillosis: the 2020 ECMM/ISHAM Consensus Criteria for Research and Clinical Guidance

Overview

Journal Lancet Infect Dis

Specialty Infectious Diseases

Date 2020 Dec 17

PMID 33333012

Citations 437

Authors

Philipp Koehler

Matteo Bassetti

Arunaloke Chakrabarti

Sharon C A Chen

Arnaldo Lopes Colombo

Martin Hoenigl

Nikolay Klimko

Cornelia Lass-Florl

Rita O Oladele

Donald C Vinh

Li-Ping Zhu

Boris Boll

Roger Bruggemann

Jean-Pierre Gangneux

John R Perfect

Thomas F Patterson

Thorsten Persigehl

Jacques F Meis

Luis Ostrosky-Zeichner

P Lewis White

Paul E Verweij

Oliver A Cornely

Affiliations

Soon will be listed here.

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.

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