4.6 Article

COVID-19-Associated Pulmonary Aspergillosis in a Tertiary Hospital

Journal

JOURNAL OF FUNGI
Volume 8, Issue 2, Pages -

Publisher

MDPI
DOI: 10.3390/jof8020097

Keywords

COVID-19; Aspergillosis; CAPA; mortality

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The study aims to assess the prevalence of COVID-19-associated pulmonary aspergillosis (CAPA) and examine the associated risk factors and their impact on mortality. Among 300 patients with COVID-19, 11.7% were diagnosed with CAPA. Independent risk factors for CAPA diagnosis were age, chronic lung disease, and treatment with tocilizumab. Age and CAPA diagnosis were also independently associated with mortality.
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.

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