The Value of the Galactomannan Test in Diagnosing COVID-۱۹–Associated Pulmonary Aspergillosis: A Review

COVID–۱۹–associated pulmonary aspergillosis (CAPA) is a complication of COVID-۱۹. Galactomannan (GM) is a non-invasive test used to diagnose invasive aspergillosis. We collected the existing studies on the diagnostic value of GM to determine a GM level for predicting CAPA. All articles on the value of GM in CAPA diagnosis published until November ۲۰۲۳ were reviewed. The main databases were searched using the following keywords: “aspergillus”, “aspergillosis”, “SARS-CoV-۲”, “COVID”, “۲۰۱۹ ncovnCOV”, “novel coronavirus”, “COVID-۱۹”, “galactomannan”, and “CAPA”. Studies with reported levels of serum or BAL GM were included. Patients were classified into two groups: non-confirmed and proven aspergillosis. Finally, the receiver operating characteristic (ROC) curve analysis was used to determine a GM level to predict the likelihood of CAPA. A total of ۲۶ articles were selected, of which ۲۳۹ patients were included. A count of ۱۲۳ patients (۵۰%) were in the non-confirmed group and ۱۲۴ (۵۰%) patients were proven. The median serum GM was ۰.۵۱ in the non-confirmed group and ۰.۴۷ in the proven group (p= ۰.۷۳). The level of GM in BAL fluid was ۰.۱۰ in the non-confirmed and ۲.۸۰ in the proven group, which was statistically different (p<۰.۰۰۱). With ۸۱.۳ % sensitivity and ۷۹.۵% specificity, the BAL GM cut-off was ۱.۰۱ ODI. The results showed that BAL GM ≥۱.۰۱ can be used to predict CAPA. Serum GM did not show any predictive value in diagnosing CAPA. However, BAL GM level can be a reliable diagnostic test in patients with CAPA.

کلیدواژه ها:

Galactomannan ، Aspergillosis ، SARS-CoV-۲ ، COVID-۱۹ ، Bronchoalveolar Lavage ، fungi ، Viral Diseases ، Invasive fungal infections