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. 2022 Jan 19;8(2):97.
doi: 10.3390/jof8020097.

COVID-19-Associated Pulmonary Aspergillosis in a Tertiary Hospital

García-Clemente Marta  1 , Forcelledo-Espina Lorena  2 , Martínez-Vega Laura  1 , Lanza-Martínez Angela  1 , Leoz-Gordillo Blanca  2 , Albillos-Almaraz Rodrigo  2 , Solís-García Marta  1 , Melón-García Santiago  3 , Pérez-Martínez Liliana  1 , Sánchez-Nuñez Maria Luisa  4 , Peláez-García de la Rasilla Teresa  3
Affiliations

COVID-19-Associated Pulmonary Aspergillosis in a Tertiary Hospital

García-Clemente Marta et al. J Fungi (Basel). .

Abstract

Our study aims to assess the prevalence of CAPA (COVID-19-associated pulmonary aspergillosis) and describe the associated risk factors and their impact on mortality. A prospective study was conducted. We included patients with COVID-19 disease who were admitted to the ICU with a diagnosis of respiratory failur. Mycological culture and other biomarkers (calcofluor staining, LFD, LFA, PCR, GM, and B-D-glucan) were performed. A total of 300 patients were included in the study. Thirty-five patients were diagnosed with CAPA (prevalence 11.7%). During admission, 57 patients died (19%), and, in the group of CAPA patients, mortality was 31.4%. In multivariate analysis, independent risk factors associated with CAPA diagnosis were age (OR: 1.05; 95% CI 1.01-1.09; p = 0.037), chronic lung disease (OR: 3.85; 95% CI 1.02-14.9; p = 0.049) and treatment with tocilizumab during admission (OR: 14.5; 95% 6.1-34.9; p = 0.001). Factors independently associated with mortality were age (OR: 1.06; 95% CI 1.01-1.11; p = 0.014) and CAPA diagnosis during admission (OR: 3.34; 95% CI 1.38-8.08; p = 0.007). CAPA is an infection that appears in many patients with COVID-19 disease. CAPA is associated with high mortality rates, which may be reduced by early diagnosis and initiation of appropriate antifungal therapy, so screening of COVID-19 ARDS (acute respiratory distress syndrome) patients for CAPA is essential.

Keywords: Aspergillosis; CAPA; COVID-19; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

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