Covid-19
Conditions
Keywords
Invasives mycoses, aspergillosis, pneumocystosis, mucormycosis
Brief summary
Characterization of fungal infections in COVID-19 infected and mechanically ventilated patients in ICU
Detailed description
Currently, ICU patients with ARDS, whatever the etiology, are not systematically screened for the detection of respiratory fungal infections. Here, the protocol will be in two steps: First step COVID-19 patients hospitalized in ICU for ARDS will benefit for a systematic screening with a fungal respiratory syndromic panel once or twice a week from entry to discharge from ICU, with minimum 3 samples when discharge occurs after 15 days:: * Sample: tracheal aspiration, bronchial aspiration, BAL * Fungal respiratory panel: samples will be processed in each lab for culture without direct examination nor stained smears, and real-time PCR will be performed for Aspergillus, Pneumocystis jirovecii and mucormycetes * Results will be given to ICU in order to optimize the management of the patient Second step Complementary analysis will be performed in order to finalize the diagnostic and to differentiate between colonization and infection, with: * Serum detection of galactomannan and serum Aspergillus PCR in case of positive respiratory sample for Aspergillus * Serum/plasma beta-D-glucan detection in case of positive respiratory sample for Pneumocystis jirovecii * Serum mucorales PCR in case of positive respiratory sample for mucorales This second step is possible in most of the labs, but when necessary a confirmation test can be externalized. A process of DNA transmission to a reference lab within each region will be implemented. This second step will allow to classify infections as probable or proven according to international recommendations. Case report form (CRF) A short but standardized CRF will be proposed to all centers in order to collect demographic data and the essential clinical and laboratory data during the survey.
Interventions
None listed
Sponsors
Rennes University Hospital
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
: * ICU patients COVID-19 diagnosed by RT-PCR * Intubated and mechanically ventilated patients * Adult patients * Patients (or legal representative) informed on the research without opposition Non-inclusion criteria : * Patients \<18 years old * People of full age who are the subject of a judicial safeguard,
Exclusion criteria
* Patient, or legal representative opposing the pursuit of the research * Patients under judicial protection will be excluded as soon as the investigator becomes aware of their status.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Opportunistic fungal co-infections. | at 12 months | Prevalence of opportunistic fungal co-infections. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Median time | at 12 months | Determination of the median time between entry in ICU and beginning of ARDS and (i) colonization and (ii) probable/proven infection with Aspergillus, Pneumocystis jirovecii and mucormycetes |
| Time between diagnosis and targeted treatment | at ICU discharge, up to 1 month | Evaluation of the time between diagnosis and targeted treatment |
| Preventive strategies | At 12 months | Number of proposals for evaluation of preventive strategies if necessary, because of high incidence, in terms of chemoprophylaxis and/or environmental measures |
Countries
France
Outcome results
None listed