It is now well known that patients with SARS-CoV-2 infection admitted in ICU and mechanically ventilated are at risk of developing invasive pulmonary aspergillosis (IPA). Nevertheless, symptomatology of IPA is often atypical in mechanically ventilated patients, and radiological aspects in SARS-CoV-2 pneumonia and IPA are difficult to differentiate. In this context, the significance of the presence of Aspergillus in airway specimens (detected by culture, galactomannan antigen or specific PCR) remains to be fully understood. To decipher the relevance of the detection of Aspergillus, we performed a comprehensive review of all published cases of respiratory Aspergillus colonisation and IPA in COVID-19 patients. The comparison of patients receiving or not antifungal treatment allowed us to highlight the most important criteria for the decision to treat. The comparison of surviving and non-surviving patients made it possible to unveil criteria associated with mortality that should be taken into account in the treatment decision.

中文翻译：

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ICU COVID-19患者气道曲霉菌检测意义综述

现在众所周知，入住 ICU 并接受机械通气的 SARS-CoV-2 感染患者有发生侵袭性肺曲霉病 (IPA) 的风险。然而，机械通气患者的 IPA 症状通常不典型，并且 SARS-CoV-2 肺炎和 IPA 的放射学方面难以区分。在这种情况下，气道标本（通过培养、半乳甘露聚糖抗原或特异性 PCR 检测）中存在曲霉的重要性仍有待充分了解。为了破译曲霉菌检测的相关性，我们对所有已发表的呼吸道曲霉菌病例进行了全面审查。COVID-19 患者的定植和 IPA。接受或未接受抗真菌治疗的患者的比较使我们能够强调决定治疗的最重要标准。存活和未存活患者的比较使得揭示与死亡率相关的标准成为可能，这些标准应在治疗决策中予以考虑。