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- W4313222608 abstract "Introduction: Fungal co-infection in ICU patients hospitalized with COVID-19 pneumonia has been described. Biomarkers such as galactomannan (GM) from serum and bronchoalveolar lavage have low sensitivity. 1,3 Beta-d-glucan (BdG) may have higher sensitivity, but it lacks specificity. In this study, we examined the clinical outcome and utility of fungal biomarkers in the diagnosis of fungal co-infections in ICU COVID-19 patients. Methods: Intensive care Unit (ICU) COVID-19 patients treated for fungal co-infections (COVID+ Fungal co-infection) were compared to ICU COVID-19 patients without fungal co-infections as controls. The primary outcome of this study were to determine the utility of fungal biomarkers in COVID+ Fungal-co-infected patients compared to similar patients without fungal infection (control group). Patients were entered into a spreadsheet and then analyzed using SPSS (ver. 27, IBM, Inc.). Mean (± SD) and percentages were reported. Results: A total of 76 ICU COVID-19+ patients were identified. 54 were COVID+ fungal co-infected, 22 were COVID+ control patients. 53 (69.7%) were male. Most patients were Caucasian (76%), with 7.9% Hispanic and 6% African American. Mean (± SD) age was 59.6 ± 12.0. Eighty-six percent of patients received mechanical ventilation, 59% underwent bronchoscopy and expired during hospitalization, respectively. COVID associated pulmonary aspergillosis (CAPA) was diagnosed in 21% of COVID+ Fungal co-infected group. BdG was obtained in 17 (31.5%) COVID+ Fungal+ compared to 4.5% in control patients (p=0.012). Fungal culture was obtained in 40 (74%) COVID+ Fungal+ group compared to 5.4% in control group (p< 0.001). Aspergillus antigen in BAL in 52% COVID+ Fungal+ patients compared to 5.4% in controls (p< 0.001). Similarly, 54 (71%) patients received antifungal therapy (97% with positive fungal culture was treated compared to 41% with negative culture, p< 0.001). Most patients (84%) with positive fungal culture were treated with voriconazole. Conclusions: Fungal biomarkers including BdG and GM were more likely to be positive in COVID-19+ Fungal-co-infection. Use of the fungal biomarkers (BdG, GM) were used in a minority COVID+ patients for diagnosis. Fungal culture did prompt anti-fungal therapy, mainly voriconazole treatment." @default.
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- W4313222608 date "2022-12-15" @default.
- W4313222608 modified "2023-10-14" @default.
- W4313222608 title "461: UTILITY OF FUNGAL BIOMARKERS IN CRITICALLY ILL PATIENTS WITH COVID-19 AND FUNGAL COINFECTION" @default.
- W4313222608 doi "https://doi.org/10.1097/01.ccm.0000907572.99953.b2" @default.
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