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Observational Study

Multinational Observational Cohort Study of COVID-19-Associated Pulmonary Aspergillosis1

Nico A F Janssen et al. Emerg Infect Dis. 2021 Nov.

Abstract

We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease-associated pulmonary aspergillosis (CAPA). We found 10%-15% CAPA incidence among 823 patients in 2 cohorts. Several factors were independently associated with CAPA in 1 cohort and mortality rates were 43%-52%.

Keywords: Aspergillus; COVID-19; SARS; SARS-CoV-2; coronavirus; coronavirus disease; epidemiology; fungi; invasive pulmonary aspergillosis; mortality rates; mycology; respiratory infections; risk factors; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

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Figures

Figure 1
Figure 1
Flowchart of the study inclusion process for a multinational observational study of CAPA in 3 countries in Europe, 2020. A) Discovery cohort; B) validation cohort. For further analyses, patients with proven, probable, and possible CAPA were designated to the CAPA group. Patients were classified to the CAPA excluded group when they had >1 negative mycological test according to 2020 ECMM/ISHAM classification consensus criteria (11). Patients who did not undergo any of the mycological tests were designated to the CAPA not classifiable group. *Value includes 6 patients in whom CAPA was excluded at the time of autopsy. CAPA, COVID-19–associated pulmonary aspergillosis; COVID-19, coronavirus disease; ECMM/ISHAM, European Confederation for Medical Mycology/International Society for Human and Animal Mycology; ICU, intensive care unit.
Figure 2
Figure 2
Kaplan-Meier survival curves comparing patients with CAPA and those classified as CAPA excluded in a multinational observational study. A) Discovery cohort; B) validation cohort. Survival analysis performed by using Mantel-Cox log rank test. Survival over time differs significantly in the discovery cohort (n = 279); median estimated survival in the CAPA group is 42.0 days (p = 0.015 by log rank test). In the validation cohort (n = 209), survival over time is not significantly different between the 2 groups (p = 0.065 by log rank test). CAPA, COVID-19–associated pulmonary aspergillosis; COVID-19, coronavirus disease; ICU, intensive care unit.
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References

    1. Koehler P, Cornely OA, Böttiger BW, Dusse F, Eichenauer DA, Fuchs F, et al. COVID-19 associated pulmonary aspergillosis. Mycoses. 2020;63:528–34. 10.1111/myc.13096 - DOI - PMC - PubMed
    1. van Arkel ALE, Rijpstra TA, Belderbos HNA, van Wijngaarden P, Verweij PE, Bentvelsen RG. COVID-19–associated pulmonary aspergillosis. Am J Respir Crit Care Med. 2020;202:132–5. 10.1164/rccm.202004-1038LE - DOI - PMC - PubMed
    1. Rutsaert L, Steinfort N, Van Hunsel T, Bomans P, Naesens R, Mertes H, et al. COVID-19-associated invasive pulmonary aspergillosis. Ann Intensive Care. 2020;10:71. 10.1186/s13613-020-00686-4 - DOI - PMC - PubMed
    1. Wang J, Yang Q, Zhang P, Sheng J, Zhou J, Qu T. Clinical characteristics of invasive pulmonary aspergillosis in patients with COVID-19 in Zhejiang, China: a retrospective case series. Crit Care. 2020;24:299. 10.1186/s13054-020-03046-7 - DOI - PMC - 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:e48–9. 10.1016/S2213-2600(20)30237-X - DOI - PMC - PubMed

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