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Clinical manifestations and outcomes of fungus-associated asthma: A multi-institution database study in Taiwan

Authors :
Yu-Lun, Lo
Horng-Chyuan, Lin
Chun-Yu, Lo
Hung-Yu, Huang
Ting-Yu, Lin
Chiung-Hung, Lin
Meng-Heng, Hsieh
Yueh-Fu, Fang
Shu-Min, Lin
Yu-Tung, Huang
Ting-Wei, Liao
Chun-Hua, Wang
Chun-Yu, Lin
Source :
Microbiological Research. 266:127234
Publication Year :
2023
Publisher :
Elsevier BV, 2023.

Abstract

Differences in the clinical phenotypes and outcomes of fungus-associated asthma remain unclear. We aimed to investigate the presentation of asthmatics with fungal sensitization and/or positive fungal isolates.Clinical characteristics, pulmonary function, microbiological data, allergy test reports, emergency department (ED) visits and hospitalizations were retrieved from the Chang Gung Research Database between 2010 and 2018; the largest electronic medical record-based database in Taiwan. Follow-up care was provided to each patient for 3 years.A total of 30,754 asthmatics were enrolled, and 7976 were eligible for analysis after applying the exclusion criteria. Of these patients, 694 had sputum examinations for fungi. The patients were divided into four groups: group 1, neither fungal sensitization nor fungal isolates in the sputum (n = 386); group 2, positive fungal sensitization (n = 58); group 3, positive fungal isolates (n = 217); and group 4, concomitant positive fungal sensitization and positive fungal isolates (n = 33). Asthmatic patients with fungal sensitization (groups 2 and 4) demonstrated significantly higher IgE levels compared with those without (groups 1 and 3). Group 4 patients had a higher frequency of hospitalization. Amongst patients under Global Initiative for Asthma (GINA) step 4-5 therapies, group 4 asthmatics possessed significantly higher incidence of respiratory failure.The prevalence of fungal sensitization and fungal isolates from sputum were even across asthmatic severities, but the clinical impact of fungi may be more significant among patients with more severe disease.

Details

ISSN :
09445013
Volume :
266
Database :
OpenAIRE
Journal :
Microbiological Research
Accession number :
edsair.doi.dedup.....00d2a1c36770639b5a74c9be6dd64111
Full Text :
https://doi.org/10.1016/j.micres.2022.127234