Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 28;60(5):myac031.
doi: 10.1093/mmy/myac031.

Investigation of the value of precipitins in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with a positive marker for Aspergillus species

A P Bellanger  1   2   3 , S Lallemand  1 , A Tumasyan Horikian  1 , J C Navellou  4 , C Barrera  1   2   3 , A Rouzet  1   2   3 , E Scherer  1   2   3 , G Reboux  1   2 , G Piton  4 , L Millon  1   2   3
Affiliations

Investigation of the value of precipitins in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with a positive marker for Aspergillus species

A P Bellanger et al. Med Mycol. .

Abstract

Although a high prevalence of COVID-19-associated pulmonary aspergillosis has been reported, it is still difficult to distinguish between colonization with Aspergillus fumigatus and infection. Concomitantly, similarities between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hypersensitivity pneumonitis were suggested. The objective of this study was to investigate retrospectively if precipitin assays targeting A. fumigatus could have been useful in the management of SARS-CoV-2 patients hospitalized in an Intensive Care Unit (ICU) in 2020. SARS-CoV-2 ICU patients were screened for Aspergillus co-infection using biomarkers (galactomannan antigen, qPCR) and culture of respiratory samples (tracheal aspirates and bronchoalveolar lavage). For all these patients, clinical data, ICU characteristics and microbial results were collected. Electrosyneresis assays were performed using commercial A. fumigatus somatic and metabolic antigens. ELISA were performed using in-house A. fumigatus purified antigen and recombinant antigens.Our study population consisted of 65 predominantly male patients, with a median ICU stay of 22 days, and a global survival rate of 62%. Thirty-five patients had at least one positive marker for Aspergillus species detection. The number of arcs obtained by electrosyneresis using the somatic A. fumigatus antigen was significantly higher for these 35 SARS-CoV-2 ICU patients (P 0.01, Welch's t-test). Our study showed that SARS-CoV-2 ICU patients with a positive marker for Aspergillus species detection more often presented precipitins towards A. fumigatus. Serology assays could be an additional tool to assess the clinical relevance of the Aspergillus species in respiratory samples of SARS-CoV-2 ICU patients.

Lay summary: This study showed retrospectively that precipitin assays, such as electrosyneresis, could be helpful to distinguish between colonization and infection with Aspergillus fumigatus during the management of severe acute respiratory syndrome Coronavirus-2 (SARS CoV-2) patients in an intensive care unit.

Keywords: Aspergillus fumigatus; SARS-CoV-2; electrosyneresis; precipitins; somatic antigen; tracheal aspirates.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Illustration of precipitation arcs obtained by electrosyneresis.
Figure 2.
Figure 2.
Serology results. (A) Significant difference by electrosyneresis between the two groups studied using the somatic A. fumigatus antigen (P 0.01, Welch's t-test). (B) No significant difference by electrosyneresis between the two groups studied using the metabolic A. fumigatus antigen (Welch's t-test). (C) No significant difference by ELISA using the purified A. fumigatus antigen (Welch's t-test). (D) No significant difference by ELISA using the recombinant G6PI antigen (Welch's t test). (E) No significant difference by ELISA using the recombinant GLPV antigen (Welch's t-test).
Figure 3.
Figure 3.
Serology results using in-house ELISA, when considering the groups probable CAPA (n = 12), colonized (n = 23) and non-colonized (n = 30).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Song YG, Song HS.. COVID-19, a clinical syndrome manifesting as hypersensitivity pneumonitis. Infect Chemother. 2020; 52: 110–112. - PMC - PubMed
    1. Vuitton DA, Vuitton L, Seillès E, Galanaud P.. A plea for the pathogenic role of immune complexes in severe Covid-19. Clin Immunol. 2020; 217: 108493. - PMC - PubMed
    1. Selman M, Pardo A, King TE Jr.. Hypersensitivity pneumonitis: insights in diagnosis and pathobiology. Am J Respir Crit Care Med. 2012; 186: 314–324. - PubMed
    1. Alanio A, Dellière S, Fodil S, Bretagne S, Mégarbane B.. Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19. Lancet Respir Med. 2020; 8: e48–e49. - PMC - PubMed
    1. Gangneux JP, Dannaoui E, Fekkar Aet al. . Fungal infections in mechanically ventilated patients with COVID-19 during the first wave: the French multicentre MYCOVID study. Lancet Respir Med. 2022; 10: 180–190. - PMC - PubMed