Cargando…
987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients
BACKGROUND: Invasive pulmonary aspergillosis (IPA) is increasingly recognized as a complication of severe respiratory viral infections (RVIs), including influenza and COVID-19. However, the incidence and outcomes of IPA following other RVIs is not well-described. We hypothesized that IPA may be an u...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643971/ http://dx.doi.org/10.1093/ofid/ofab466.1181 |
_version_ | 1784609977471598592 |
---|---|
author | De Los Santos, Bertha A Barnes, Brian J Britt, Nicholas |
author_facet | De Los Santos, Bertha A Barnes, Brian J Britt, Nicholas |
author_sort | De Los Santos, Bertha A |
collection | PubMed |
description | BACKGROUND: Invasive pulmonary aspergillosis (IPA) is increasingly recognized as a complication of severe respiratory viral infections (RVIs), including influenza and COVID-19. However, the incidence and outcomes of IPA following other RVIs is not well-described. We hypothesized that IPA may be an underreported complication of non-influenza RVIs. The objective of this study was to quantify the incidence and associated outcomes of IPA following RVI in hospitalized patients. METHODS: We conducted a single-center retrospective cohort study of adult hospitalized patients with RVI diagnosed by multiplex PCR-based assay at the University of Kansas Hospital (Kansas City, Kansas) from September 2018-October 2019. Patients with a diagnosis of proven or probable IPA prior to RVI and those with hospital admission < 24 h were excluded from analysis. Proven or probable IPA was defined according to EORTC/MSGERC consensus definitions. The primary outcome was 1-year all-cause mortality. RESULTS: A total of 195 patients met study criteria and were included in the analysis. The most common types of RVI observed were rhinovirus/enterovirus (57.9%, n=113), parainfluenza (13.3%, n=26), influenza (8.2%, n=16), and respiratory syncytial virus (7.7%, n=15). The cumulative incidence of IPA infection within 6 weeks of RVI was 5.6% (n=11). Excluding patients co-infected with multiple respiratory viruses (n=5), IPA was numerically more likely to occur following influenza compared to non-influenza RVI (12.5% [ n=2/16] vs. 4.6% [n=8/174]; odds ratio, 2.96; 95% confidence interval [CI], 0.57-15.3; P=0.176). Overall, one-year all-cause mortality was 20% (n=39/195) in this cohort. Development of IPA as a complication of RVI was associated with a significant decrease in 1-year survival (hazard ratio [HR], 3.04; 95% CI, 1.19-7.78; P=0.021), and this relationship persisted after adjustment for age (HR, 2.77; 95% CI, 1.08-7.10; P=0.034). CONCLUSION: In a cohort of hospitalized patients with RVI, 5.6% of patients developed proven or probable IPA. Although IPA was more likely to occur in patients with influenza, this complication was also observed with other types of RVI. Invasive pulmonary aspergillosis may be an underappreciated complication of non-influenza RVI in hospitalized patients and warrants continued study. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-8643971 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-86439712021-12-06 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients De Los Santos, Bertha A Barnes, Brian J Britt, Nicholas Open Forum Infect Dis Poster Abstracts BACKGROUND: Invasive pulmonary aspergillosis (IPA) is increasingly recognized as a complication of severe respiratory viral infections (RVIs), including influenza and COVID-19. However, the incidence and outcomes of IPA following other RVIs is not well-described. We hypothesized that IPA may be an underreported complication of non-influenza RVIs. The objective of this study was to quantify the incidence and associated outcomes of IPA following RVI in hospitalized patients. METHODS: We conducted a single-center retrospective cohort study of adult hospitalized patients with RVI diagnosed by multiplex PCR-based assay at the University of Kansas Hospital (Kansas City, Kansas) from September 2018-October 2019. Patients with a diagnosis of proven or probable IPA prior to RVI and those with hospital admission < 24 h were excluded from analysis. Proven or probable IPA was defined according to EORTC/MSGERC consensus definitions. The primary outcome was 1-year all-cause mortality. RESULTS: A total of 195 patients met study criteria and were included in the analysis. The most common types of RVI observed were rhinovirus/enterovirus (57.9%, n=113), parainfluenza (13.3%, n=26), influenza (8.2%, n=16), and respiratory syncytial virus (7.7%, n=15). The cumulative incidence of IPA infection within 6 weeks of RVI was 5.6% (n=11). Excluding patients co-infected with multiple respiratory viruses (n=5), IPA was numerically more likely to occur following influenza compared to non-influenza RVI (12.5% [ n=2/16] vs. 4.6% [n=8/174]; odds ratio, 2.96; 95% confidence interval [CI], 0.57-15.3; P=0.176). Overall, one-year all-cause mortality was 20% (n=39/195) in this cohort. Development of IPA as a complication of RVI was associated with a significant decrease in 1-year survival (hazard ratio [HR], 3.04; 95% CI, 1.19-7.78; P=0.021), and this relationship persisted after adjustment for age (HR, 2.77; 95% CI, 1.08-7.10; P=0.034). CONCLUSION: In a cohort of hospitalized patients with RVI, 5.6% of patients developed proven or probable IPA. Although IPA was more likely to occur in patients with influenza, this complication was also observed with other types of RVI. Invasive pulmonary aspergillosis may be an underappreciated complication of non-influenza RVI in hospitalized patients and warrants continued study. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2021-12-04 /pmc/articles/PMC8643971/ http://dx.doi.org/10.1093/ofid/ofab466.1181 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Poster Abstracts De Los Santos, Bertha A Barnes, Brian J Britt, Nicholas 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients |
title | 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients |
title_full | 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients |
title_fullStr | 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients |
title_full_unstemmed | 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients |
title_short | 987. Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients |
title_sort | 987. clinical epidemiology and outcomes of invasive pulmonary aspergillosis as a complication of respiratory viral infection in hospitalized patients |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643971/ http://dx.doi.org/10.1093/ofid/ofab466.1181 |
work_keys_str_mv | AT delossantosberthaa 987clinicalepidemiologyandoutcomesofinvasivepulmonaryaspergillosisasacomplicationofrespiratoryviralinfectioninhospitalizedpatients AT barnesbrianj 987clinicalepidemiologyandoutcomesofinvasivepulmonaryaspergillosisasacomplicationofrespiratoryviralinfectioninhospitalizedpatients AT brittnicholas 987clinicalepidemiologyandoutcomesofinvasivepulmonaryaspergillosisasacomplicationofrespiratoryviralinfectioninhospitalizedpatients |