Factors affecting mortality in COVID-19-associated pulmonary aspergillosis: An international ID-IRI study.

Background: This study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA). Methods: In this cross-sectional study, data from 23 centers across 15 countries, spanning the period of March 2020 to December 2021, were retrospectively collected. The study population comprised patients who developed invasive pulmonary aspergillosis while being treated for COVID-19 in the intensive care unit. Cox regression and decision tree analyses were used to identify factors associated with mortality in patients with CAPA. Results: A total of 162 patients (males, 65.4 %; median age: 64 [25th-75th: 54.0-73.8] years) were included in the study, of whom 113 died during the 90-day follow-up period. The median duration from CAPA diagnosis to death was 12 (25th-75th: 7-19) days. In the multivariable Cox regression model, an age of ≥65 years (hazard ratio [HR]: 2.05, 95 % confidence interval [CI]: 1.37-3.07), requiring vasopressor therapy at the time of CAPA diagnosis (HR: 1.80, 95 % CI: 1.17-2.76), and receiving renal replacement therapy at the time of CAPA diagnosis (HR: 2.27, 95 % CI: 1.35-3.82) were identified as predictors of mortality. Decision tree analysis revealed that patients with CAPA aged ≥65 years who received corticosteroid treatment for COVID-19 displayed higher mortality rates (estimated rate: 1.6, observed in 46 % of patients). Conclusion: This study concluded that elderly patients with CAPA who receive corticosteroids are at a significantly higher risk of mortality, particularly if they experience multiorgan failure.

Case series of Rapidly growing Mycobacterial Post-operative surgical site infection in kidney transplant recipients.

Background: Case series of Rapidly growing Mycobacterial Post-operative wound infection with Mycobacterium Abscessus and/or Mycobacterium Chelone in 4 cases of kidney transplant adult recipient who presented within 6 months of transplant. Case presentations: We report 4 cases of Renal transplant recipients with post-surgical site infection with NTM-69-year-old with post-surgical wound infection with microbiologically proven Mycobacterium Abscessus who discontinued treatment and further presented with intra-abdominal abscess. Next case was 61 years male presented with nodular swellings at surgical site with US findings of intra-abdominal muscle abscess was tested culture positive for Mycobacterium Chelonae and Abscessus.Third case was 34 years male presented with surgical wound infection which was positive for AFB by ZN stain. Lastly,46 years old male patient known hypertensive and E.S.R.D, had culture proven Mycobacterium Abscessus surgical wound infection. All the four cases had their renal transplant at Philippines at different centres. Conclusions: Nontuberculous mycobacteria infection is important cause of morbidity in kidney transplant recipient and high index of suspicion with early diagnosis and treatment is crucial for successful outcome.

Effectiveness of the neutralizing antibody sotrovimab among high-risk patients with mild-to-moderate SARS-CoV-2 in Qatar.

OBJECTIVES: To estimate the real-world effectiveness of sotrovimab against severe, critical, or fatal COVID-19 in Qatar at a time in which most SARS-CoV-2 incidences occurred due to the BA.2 Omicron subvariant. METHODS: We conducted a matched case-control study among all individuals eligible for sotrovimab treatment per United States Food and Drug Administration guidelines in the resident population of Qatar. The odds of progression to severe forms of COVID-19 were compared in cases (treatment group) versus controls (eligible patients who opted not to receive the treatment). Subgroup analyses were conducted. RESULTS: A total of 3364 individuals were eligible for sotrovimab treatment during the study period, of whom 519 individuals received the treatment, whereas the remaining 2845 constituted the controls. The adjusted odds ratio of disease progression to severe, critical, or fatal COVID-19 comparing the treatment group to the control group was 2.67 (95% confidence interval 0.60-11.91). In the analysis including only the subgroup of patients at higher risk of severe forms of COVID-19, the adjusted odds ratio was 0.65 (95% confidence interval 0.17-2.48). CONCLUSION: There was no evidence for a protective effect of sotrovimab in reducing COVID-19 severity in a setting dominated by the BA.2 subvariant.