%0 Journal Article 
%A Estella García, Angel
%A Recuerda Núñez, María
%A Lagares Franco, Carolina María
%A Gracia Romero, Manuel Angel
%A Torres, Eva
%A Alados Arboledas, Juan Carlos
%A Antón Escors, Álvaro
%A González García, Clara
%A Sandar Núñez, Dolores
%A López Prieto, Dolores
%A Sánchez Calvo, Juan Manuel
%T Anticipatory Antifungal Treatment in Critically Ill Patients with SARS-CoV-2 Pneumonia
%D 2023
%@ 2309-608X
%U http://hdl.handle.net/10498/32025
%X Background. The aim of this study was to investigate the incidence of COVID-19-associated
pulmonary aspergillosis (CAPA) in critically ill patients and the impact of anticipatory antifungal
treatment on the incidence of CAPA in critically ill patients. Methods. Before/after observational
study in a mixed intensive care unit (ICU) of a university teaching hospital. The study took place
between March 2020 and June 2022. Inclusion criteria were critically ill patients with severe SARSCoV-
2 pneumonia requiring invasive mechanical ventilation. Two analysis periods were compared
according to whether or not antifungal therapy was given early. Results. A total of 160 patients with
severe SARS-CoV-2 pneumonia and invasive mechanical ventilation were included. The incidence
of CAPA in the first study period was 19 out of 58 patients (32.75%); during the second period,
after implementation of the intervention (anticipatory antifungal therapy), the incidence of CAPA
decreased to 10.78% (11 out of 102 patients). In patients with CAPA under invasive mechanical
ventilation, the mortality rate decreased from 100% to 64%. Conclusions. Anticipating antifungal
treatment in patients with SARS-CoV-2 pneumonia under invasive mechanical ventilation was
associated with a decrease in the incidence and mortality of pulmonary aspergillosis.
%K SARS-CoV-2
%K liposomal amphotericin B
%K ARDS
%K aspergillus
%K bronchoalveolar lavage
%K ICU
%~ Universidad de Cádiz