SCCM Resource Library-Managing Secondary Fungal Infections in COVID-19 Patients

Video Transcription

Video Summary

In a webinar on managing secondary fungal infections in patients with COVID-19, Dr. Ryan Mavis and Dr. Kieran Marr discussed the epidemiology, risks, diagnosis, and management of COVID-associated pulmonary aspergillosis (CAPA) and COVID-associated mucormycosis (CAM). CAPA is a fungal infection associated with severe respiratory viral infections, such as influenza and COVID-19. It is characterized by the growth of Aspergillus fungi in the respiratory tract, leading to invasive disease and poor outcomes in COVID-19 patients. Risk factors for CAPA include corticosteroid treatment, underlying pulmonary disease, and immunosuppression. Diagnosis is based on clinical, radiological, and microbiological criteria, such as positive galactomannan antigen or PCR in bronchoalveolar lavage. Management of CAPA involves antifungal therapy, with boriconazole being the recommended treatment for six weeks. Nisamokonazole and posaconazole are alternative options. In the case of azole resistance, combination therapy or liposomal amphotericin B may be used. The use of IL-6 inhibitors, such as tocilizumab, in combination with corticosteroids may increase the risk of CAPA, but the benefits of these drugs in treating severe COVID-19 should not be overlooked. As for CAM, it is a rare but severe fungal infection caused by mucor fungi and is characterized by tissue invasion and angioinvasion. Risk factors for CAM include diabetes, immunosuppression, and COVID-19 disease severity. Diagnosis is confirmed through microbiological and histopathological analysis. Treatment involves antifungal therapy with liposomal amphotericin B, and surgical debridement may be necessary in some cases. Antifungal prophylaxis is not recommended for patients with COVID-19 due to insufficient evidence, and the focus should be on early diagnosis and appropriate treatment.

Asset Subtitle

Infection, Crisis Management, 2021

Asset Caption

"This webinar discussed how to manage common secondary fungal infections commonly seen in COVID-19 patients. Webcast Recorded on Tuesday, July 27, 2021

Moderator: Ryan C. Maves, MD, FCCM, FCCP, FIDSA
Faculty: Anne Coste, MD; Kieren Marr, MD, MBA

This educational activity was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number 1 NU50CK000566-01-00). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). Its contents do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government."

Meta Tag

Content Type Presentation

Knowledge Area Infection

Knowledge Area Crisis Management

Membership Level Nonmember

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag COVID-19

Year 2021

Keywords

webinar

secondary fungal infections

COVID-19

COVID-associated pulmonary aspergillosis

COVID-associated mucormycosis

CAPA

CAM

Aspergillus fungi

diagnosis

management

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