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

  • سال انتشار: 1404
  • محل انتشار: فصلنامه آسیب شناسی ایران، دوره: 20، شماره: 2
  • کد COI اختصاصی: JR_IJP-20-2_001
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 67
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نویسندگان

Mohammadreza Salehi

Research Center for Antibiotic Stewardship & Antimicrobial Resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Jon Salmanton-García

German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany

Alireza Abdollahi

Department of Pathology, School of Medicine, Imam Khomeini Hospital Complex, Tehran, Iran

Maryam Albaji

Department of Pulmonary Diseases, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Effat Davoudi-Monfared

Department of Clinical Pharmacy, Yas Hospital Complex, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Zeinab Siami

Department of Infectious Diseases, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran

Saeed Mohammadi

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Sadegh Khodavaisy

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Pershang Nazemi

Department of Infectious Diseases, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

چکیده

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

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