Individual research recommendation details

Recommendation ID

NG191/14

Question

What are the clinical and cost effectiveness, and the safety, of specific antifungal treatments for treating suspected or confirmed COVID-19-associated pulmonary aspergillosis (CAPA), and the optimal treatment duration? When should treatment be started, stopped or modified?

Any explanatory notes
(if applicable)

P: adults, young people and children who are critically ill and have, or have had, COVID-19 as part of their acute illness and have probable or diagnosed CAPA. Subgroups of particular interest: children and young people, pregnant women, ethnicity, immunosuppression, and subgroups who have higher rates of COVID-19.

I: voriconazole, isavuconazole, liposomal amphotericin B, posaconazole, echinocandins (for example, caspofungin, anidulafungin) and amphotericin B deoxycholate.

C: Standard care (usually voriconazole)

O:
• all-cause mortality (at any time during treatment)
• number of people having 1 or more serious adverse events
• number of days without respiratory or organ support (organ support includes use of vasopressors and renal replacement therapy)
• length of stay in intensive care
• number of people having 1 or more adverse events
• treatment duration
• timing of starting treatment
• need for treatment modification
• length of hospital stays
• need for and duration of invasive mechanical ventilation
• need for switching, starting or restarting antifungal treatment

Source guidance details

Comes from guidance

COVID-19 rapid guideline: managing COVID-19

Number

NG191

Date issued

March 2021

Other details