AspiFlu

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Incidence and pathogenesis of Invasive Aspergillosis in Intensive care patients with severe Influenza

Aim

To estimate incidence of invasive pulmonary aspergillosis (IPA) in critically ill inpatients with influenza or COVID-19, and identify risk factors for infection.

Background/method

Some patients with seasonal Influenza (‘flu’) develop severe infection requiring admission to the Intensive Care Unit (ICU) to support their breathing. Recent research has suggested that when patients have such severe influenza they may be susceptible to a second infection with a mould (a type of fungus) called Aspergillus. The mortality for patients infected with both severe ‘flu and Invasive pulmonary Aspergillus (IPA) is high but life-saving antifungal treatments exist and thus it is important that a diagnosis of IA in patients with severe influenza is not missed. Unfortunately, IPA can be difficult and lengthy to diagnose in the laboratory and until recently it was only thought to occur in patients whose immune systems were severely impaired. This means that IPA in patients with severe influenza may be under-diagnosed currently and the main aim of this study is to establish how common this condition is in UK patients.

In 2020 a new coronavirus was identified as the cause of an outbreak of unexplained pneumonia in China. This coronavirus was later named ‘SARS-CoV-2’, and the disease it causes ‘COVID-19’. It is not yet known whether patients with severe COVID-19 infection are also at risk of IPA. This study offers an excellent opportunity to understand the risk of developing IPA in COVID-19 and find out whether fungal infection is contributing to the high death rate of COVID-19 patients in the ITU.  An increased risk of IPA may not just apply to these two severe viral infections of the lung- it may also be that a heightened risk of secondary Aspergillus infection applies to any patient on the ICU with severe lung infection. In order to best understand this, we also plan to enrol patients on ICU with bacterial lung infection (pneumonia)as a control group so that we can compare the rates of IPA between patients with influenza, COVID19 and bacterial infections on the ICU.

Chief investigator

Chief investigator

Tihana Bicanic

Principal investigator

Principal investigator

Dr Mansoor Bangash
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Current recruitment number
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