COVID-19 Associated Pulmonary Aspergillosis (Capa): A Narrative Review
Author(s): Abhinav Jindal*
Abstract
COVID-19 is pulmonary infection caused by Coronavirus, which result in inflammatory process in the lungs and lead to cytokine storm in the individual which finally results in immunocopromised patient and further the drugs (tocilizumab and steroids) used in the treatment of COVID-19 also suppress the immunity of the individual. This transient immuno compromised condition of the individual makes the secondary or supra added infection that might be either bacterial or fungal. One such fungal infection is COVID associated pulmonary aspergillosis. The cases of this deadly fungus are more found in the immuno compromised patients like who are severely ill and are admitted on intensive care unit and are on mechanical ventilation. The patients to get infected by this infection mostly by the 4th day of the intensive care unit admission. Symptoms and signs of the infection are similar to that of COVID-19. Three grades have been proposed for this infection such as probable, possible and proven. Usage of corticosteroids, broad spectrum antibiotics used in the treatment of COVID-19 infection and presence of any other lung disease are the risk factor for the development of this infection. Symptoms and signs of the infection are similar to that of COVID-19. Early diagnosis with the help of various diagnostic procedures like culture, serum or broncho alveolar lavage fluid galactomannan levels and histopathological finding from biopsy is very useful for treating this infection and saving the life and reducing the mortality rate. Voriconazole and isavuconazole is the first line drug used in the treatment of this infection. Prevention is done by immunomodulation.