Viral, Fungal Infections May Contribute to Nonresolving ARDS

Review links viral and fungal infections to persistent lung injury in nonresolving ARDS

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Cytomegalovirus, herpes simplex virus, and Aspergillus species contribute to nonresolving ARDS through immune dysregulation and lung injury.
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Nonresolving ARDS is characterized by persistent respiratory failure beyond 5 days of mechanical ventilation, leading to high morbidity and mortality.
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Influenza and COVID-19 are significant risk factors for invasive pulmonary aspergillosis, with mortality rates exceeding 50% in affected patients.
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Diagnostic challenges exist for viral reactivation and invasive pulmonary aspergillosis, with bronchoalveolar lavage being preferred for accurate detection.
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Fungal and viral infections may interact in ARDS, complicating treatment and outcomes, though the evidence for causality remains limited.

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