Pulmonary Aspergillosis in Critically Ill COVID-19 Patients Admitted to the Intensive Care Unit: A Retrospective Cohort Study

COVID-19-associated pulmonary aspergillosis (CAPA) is a life-threatening fungal infection that mainly affects critically ill patients. The aim of this study was to assess the incidence and clinical outcomes of putative CAPA in critically ill COVID-19 patients. This retrospective observational cohort...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2023-03, Vol.9 (3), p.315
Main Authors: Bergmann, Felix, Jorda, Anselm, Blaschke, Amelie, Gabler, Cornelia, Bohdan, Serhii, Nussbaumer-Pröll, Alina, Radtke, Christine, Zeitlinger, Markus
Format: Article
Language:English
Subjects:
Age
Antigens
Aspergillosis
Aspergillus
Austria
Body mass index
Bronchus
CAPA
Caspofungin
Chronic illnesses
Clinical outcomes
co-infection
Cohort analysis
Communication
Coronaviruses
COVID-19
Diagnosis
Disease
Drug dosages
fungal
Health aspects
Hospitalization
ICU
Immunosuppressive agents
Intensive care
IPA
Lavage
Medical imaging equipment
Medical research
Medicine, Experimental
Mortality
Pandemics
Pathogens
Patients
Pulmonary aspergillosis
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
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Summary:COVID-19-associated pulmonary aspergillosis (CAPA) is a life-threatening fungal infection that mainly affects critically ill patients. The aim of this study was to assess the incidence and clinical outcomes of putative CAPA in critically ill COVID-19 patients. This retrospective observational cohort study included 181 cases from 5 ICUs at Vienna General Hospital between January 2020 and April 2022. Patients were diagnosed with putative CAPA according to the AspICU classification, which included a positive Aspergillus culture in a bronchoalveolar lavage sample, compatible signs and symptoms, and abnormal medical imaging. The primary outcome was adjusted 60-day all-cause mortality from ICU admission in patients with vs. without putative CAPA. Secondary outcomes included time from ICU admission to CAPA diagnosis and pathogen prevalence and distribution. Putative CAPA was identified in 35 (19.3%) of 181 COVID-19 patients. The mean time to diagnosis was 9 days. Death at 60 days occurred in 18 of 35 (51.4%) patients with CAPA and in 43 of 146 (29.5%) patients without CAPA (adjusted HR (95%CI) = 2.15 (1.20-3.86, = 0.002). The most frequently isolated Aspergillus species was The prevalence of putative pulmonary aspergillosis in critically ill COVID-19 patients was high and was associated with significantly higher mortality.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof9030315