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논문 기본 정보

자료유형
학술저널
저자정보
Kim Si-Ho (Division of Infectious Diseases Samsung Changwon Hospital Sungkyunkwan University School of Medicin) Hong Jin Yeong (Division of Infectious Diseases Samsung Medical Center Sungkyunkwan University School of Medicine S) Bae Seongman (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Lee Hojin (Division of Infectious Diseases Department of Internal Medicine Dong-A University Hospital Busan Ko) Wi Yu Mi (Division of Infectious Diseases Samsung Changwon Hospital Sungkyunkwan University School of Medicin) Ko Jae-Hoon (Division of Infectious Diseases Samsung Medical Center Sungkyunkwan University School of Medicine S) Kim Bomi (Division of Infectious Diseases Department of Medicine Kangbuk Samsung Hospital Sungkyunkwan Univer) Joo Eun-Jeong (Division of Infectious Diseases Department of Medicine Kangbuk Samsung Hospital Sungkyunkwan Univer) Seok Hyeri (Division of Infectious Diseases Department of Medicine Korea University Ansan Hospital Korea Univer) Shi Hye Jin (Division of Infectious Diseases Department of Internal Medicine Gil Medical Center Gachon Universit) Yoo Jeong Rae (Department of Internal Medicine Jeju National University College of Medicine Jeju South Korea.) Hyun Miri (Division of Infectious Diseases Keimyung University Dongsan Hospital Keimyung University School of) Kim Hyun ah (Division of Infectious Diseases Keimyung University Dongsan Hospital Keimyung University School of) Jang Sukbin (Division of Infectious Diseases Department of Medicine Dankook University Hospital Dankook Universi) Mun Seok Jun (Division of Infectious Diseases Department of Internal Medicine Inje University Busan Paik Hospital) Kim Jungok (Division of Infectious Diseases Department of Internal Medicine Chungnam National University School) Kim Min-Chul (Division of Infectious Diseases Department of Internal Medicine Chung-Ang University Hospital Seoul) Jung Dong-Sik (Division of Infectious Diseases Department of Internal Medicine Dong-A University Hospital Busan Ko) Kim Sung-Han (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Peck Kyong Ran (Division of Infectious Diseases Samsung Medical Center Sungkyunkwan University School of Medicine S)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.37 No.18
발행연도
2022.5
수록면
1 - 12 (12page)
DOI
10.3346/jkms.2022.37.e134

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초록· 키워드

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Background: Coronavirus disease 2019 (COVID-19) is often accompanied by secondary infections, such as invasive aspergillosis. In this study, risk factors for developing COVID-19- associated pulmonary aspergillosis (CAPA) and their clinical outcomes were evaluated. Methods: This multicenter retrospective cohort study included critically ill COVID-19 patients from July 2020 through March 2021. Critically ill patients were defined as patients requiring high-flow respiratory support or mechanical ventilation. CAPA was defined based on the 2020 European Confederation of Medical Mycology and the International Society for Human and Animal Mycology consensus criteria. Factors associated with CAPA were analyzed, and their clinical outcomes were adjusted by a propensity score-matched model. Results: Among 187 eligible patients, 17 (9.1%) developed CAPA, which is equal to 33.10 per 10,000 patient-days. Sixteen patients received voriconazole-based antifungal treatment. In addition, 82.4% and 53.5% of patients with CAPA and without CAPA, respectively, received early high-dose corticosteroids (P = 0.022). In multivariable analysis, initial 10-day cumulative steroid dose > 60 mg of dexamethasone or dexamethasone equivalent dose) (adjusted odds ratio [OR], 3.77; 95% confidence interval [CI], 1.03?13.79) and chronic pulmonary disease (adjusted OR, 4.20; 95% CI, 1.26?14.02) were independently associated with CAPA. Tendencies of higher 90- day overall mortality (54.3% vs. 35.2%, P = 0.346) and lower respiratory support-free rate were observed in patients with CAPA (76.3% vs. 54.9%, P = 0.089). Conclusion: Our study showed that the dose of corticosteroid use might be a risk factor for CAPA development and the possibility of CAPA contributing to adverse outcomes in critically ill COVID-19 patients.
#Aspergillosis #COVID-19 #SARS-CoV-2 #Steroid

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