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

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Koehler, Philipp | Bassetti, Matteo | Chakrabarti, Arunaloke | Chen, Sharon C A | Colombo, Arnaldo Lopes | Hoenigl, Martin | Klimko, Nikolay | Lass-Flörl, Cornelia | Oladele, Rita O | Vinh, Donald C | Zhu, Li-Ping | Böll, Boris | Brüggemann, Roger | Gangneux, J.-P. | Perfect, John R | Patterson, Thomas F | Persigehl, Thorsten | Meis, Jacques F | Ostrosky-Zeichner, Luis | White, P Lewis | Verweij, Paul E | Cornely, Oliver A

Edité par CCSD ; New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001- -

International audience. 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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