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. 2021 Nov 10;7(11):948.
doi: 10.3390/jof7110948.

COVID-19-Associated Pulmonary Aspergillosis: A Single-Center Experience in Central Valley, California, January 2020-March 2021

Geetha Sivasubramanian  1 , Hebah Ghanem  1 , Michele Maison-Fomotar  1 , Ratnali Jain  2 , Robert Libke  1
Affiliations

COVID-19-Associated Pulmonary Aspergillosis: A Single-Center Experience in Central Valley, California, January 2020-March 2021

Geetha Sivasubramanian et al. J Fungi (Basel). .

Abstract

Reports of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) have been widely published across the world since the onset of the pandemic with varying incidence rates. We retrospectively studied all patients with severe COVID-19 infection who were admitted to our tertiary care center's intensive care units between January 2020 and March 2021, who also had respiratory cultures positive for Aspergillus species. Among a large cohort of 970 patients admitted to the ICU with severe COVID-19 infections during our study period, 48 patients had Aspergillus species growing in respiratory cultures. Based on the 2020 European Confederation of Medical Mycology and the International Society for Human and Animal Mycology (ECMM/ISHAM) consensus criteria, 2 patients in the study had proven CAPA, 9 had probable CAPA, and 37 had possible CAPA. The incidence of CAPA was 5%. The mean duration from a positive COVID-19 test to Aspergillus spp. being recovered from the respiratory cultures was 16 days, and more than half of the patients had preceding fever or worsening respiratory failure despite adequate support and management. Antifungals were given for treatment in 44% of the patients for a mean duration of 13 days. The overall mortality rate in our study population was extremely high with death occurring in 40/48 patients (83%).

Keywords: CAPA; Covid-19; invasive pulmonary aspergillosis.

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Conflict of interest statement

The authors have no financial interests or conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The numbers of Aspergillus species recovered from respiratory samples of intensive care unit patients at our center between January 2018 and March 2021.
Figure 2
Figure 2
The numbers of COVID-19 patients in the intensive care units and the numbers of Aspergillus species recovered from respiratory samples of intensive care unit patients at our center between March 2020 and February 2021.
See this image and copyright information in PMC

References

    1. Donnelly J.P., Chen S.C., Kauffman C.A., Steinbach W.J., Baddley J.W., Verweij P.E., Clancy C.J., Wingard J.R., Lockhart S.R., Groll A.H., et al. Revision and Update of the Consensus Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin. Infect. Dis. 2019;71:1367–1376. doi: 10.1093/cid/ciz1008. - DOI - PMC - PubMed
    1. Meersseman W., Lagrou K., Maertens J., Van Wijngaerden E. Invasive Aspergillosis in the Intensive Care Unit. Clin. Infect. Dis. 2007;45:205–216. doi: 10.1086/518852. - DOI - PubMed
    1. Huang L., Zhang N., Huang X., Xiong S., Feng Y., Zhang Y., Li M., Zhan Q. Invasive pulmonary aspergillosis in patients with influenza infection: A retrospective study and review of the literature. Clin. Respir. J. 2019;13:202–211. doi: 10.1111/crj.12995. - DOI - PubMed
    1. Vanderbeke L., Spriet I., Breynaert C., Rijnders B.J.A., Verweij P.E., Wauters J. Invasive pulmonary aspergillosis complicating severe influenza: Epidemiology, diagnosis and treatment. Curr. Opin. Infect. Dis. 2018;31:471–480. doi: 10.1097/QCO.0000000000000504. - DOI - PubMed
    1. Blot S.I., Taccone F.S., Abeele A.-M.V.D., Bulpa P., Meersseman W., Brusselaers N., Dimopoulos G., Paiva J.A., Misset B., Rello J., et al. A Clinical Algorithm to Diagnose Invasive Pulmonary Aspergillosis in Critically Ill Patients. Am. J. Respir. Crit. Care Med. 2012;186:56–64. doi: 10.1164/rccm.201111-1978OC. - DOI - PubMed