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Diagnostic performance and longitudinal analysis of fungal biomarkers in COVID-19 associated pulmonary aspergillosis

OBJECTIVES: Galactomannan lateral flow assay (GM-LFA) is a reliable test for COVID-19 associated pulmonary aspergillosis (CAPA) diagnosis. We aimed to assess the diagnostic performance of GM-LFA with different case definitions, the association between the longitudinal measurements of serum GM-ELISA,...

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Detalles Bibliográficos
Autores principales: Er, Berrin, Er, Ahmet Gorkem, Gulmez, Dolunay, Sahin, Taha Koray, Metan, Gökhan, Saribas, Zeynep, Arikan-Akdagli, Sevtap, Uzun, Omrum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628712/
https://www.ncbi.nlm.nih.gov/pubmed/37942162
http://dx.doi.org/10.1016/j.heliyon.2023.e21721
Descripción
Sumario:OBJECTIVES: Galactomannan lateral flow assay (GM-LFA) is a reliable test for COVID-19 associated pulmonary aspergillosis (CAPA) diagnosis. We aimed to assess the diagnostic performance of GM-LFA with different case definitions, the association between the longitudinal measurements of serum GM-ELISA, GM-LFA, and the risk of death. METHODS: Serum and nondirected bronchial lavage (NBL) samples were periodically collected. The sensitivity and specificity analysis for GM-LFA was done in different time periods. Longitudinal analysis was done with the joint model framework. RESULTS: A total of 207 patients were evaluated. On the day of CAPA diagnosis, serum GM-LFA had a sensitivity of 42 % (95 % CI: 23–63) and specificity of 82 % (95 % CI: 78–84), while NBL GM-LFA had a sensitivity of 73 % (95 % CI: 45–92), specificity of 85 % (95 % CI: 76–91) for CAPA. Sensitivity decreased through the following days in both samples. Univariate joint model analysis showed that increasing GM-LFA and GM-ELISA levels were associated with increased mortality, and that effect remained same with serum GM-ELISA in multivariate joint model analysis. CONCLUSION: GM-LFA, particularly in NBL samples, seems to be a reliable method for CAPA diagnosis. For detecting patients with higher risk of mortality, longitudinal measurement of serum GM-ELISA can be useful.