ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
A National Strategy to Diagnose Coronavirus Disease 2019-Associated Invasive Fungal Disease in the Intensive Care Unit.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04848831 (Diagnosis of Invasive Pulmonary Aspergillosis), which is not on this map. Cited by 309 papers, 10 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diagnosis of Invasive Pulmonary Aspergillosis (IPA) - Specific Testing in Bronchial Secretions Versus Bronchoalveolar Fluid in Patients With and Without COVID-19
Who cites it
309 citing papers in PubMed, 10 syntheses or guidelines pooled it, 442 citations in OpenAlex.
- Incidence, mortality and risk factors of invasive pulmonary aspergillosis in critically ill patients during the COVID-19 era: a global systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2026Pooled it
- Antifungal prophylaxis among critically ill COVID-19 patients: a meta-analysis and systematic review.BMC infectious diseases · 2026Pooled it
- The impact of different therapies on invasive pulmonary aspergillosis in patients with severe fever and thrombocytopenia syndrome: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Guideline
- Candidemia Following Severe COVID-19 in Hospitalised and Critical Ill Patients: A Systematic Review and Meta-Analysis.Mycoses · 2024Pooled it
- CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis.Clinical imaging · 2022Pooled it
- Pooled it
- Defining COVID-19-associated pulmonary aspergillosis: systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022Pooled it
- Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis.Mycopathologia · 2022Pooled it
- Worldwide prevalence of microbial agents' coinfection among COVID-19 patients: A comprehensive updated systematic review and meta-analysis.Journal of clinical laboratory analysis · 2022Pooled it
- COVID-19-Associated Fungal Co-Infections: Pathogenesis, Diagnostics, Biomarkers, and Therapeutic Strategies.Journal of clinical medicine · 2026Review
- Invasive pulmonary aspergillosis following mild Covid-19 in an autologous hematopoietic stem cell transplant recipient: A case report.Medical mycology case reports · 2026Article
- Review of the Microbial Spectrum of Mixed Respiratory Fungal Infections.Journal of epidemiology and global health · 2026Review
- Review
- Unraveling the complexities: A comprehensive review of severe fever with thrombocytopenia syndrome and its associated complications.iScience · 2026Review
- Fungal infections of the lung during and after the COVID-19 pandemic: Retrospective observational comparison.Medicine · 2026Observational
- Biomarkers in the Diagnosis of Aspergillosis.Journal of fungi (Basel, Switzerland) · 2026Review
- Candida species identified by MAL-DI-TOF and antifungal susceptibility in hospitalized patients with COVID-19 in Peru.Revista peruana de medicina experimental y salud publica · 2026Observational
- Characteristics of mycological criteria for the diagnosis of invasive mold infections in patients with severe burn injury.Journal of clinical microbiology · 2026Article
- CT Radiomics for the Early Identification of Fungal Co-infection in Immunocompromised Patients with Viral PneumoniaCurrent medical imaging · 2026Article
249 more citing papers are in PubMed but not listed here.
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Authors and funding
24 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFungal coinfection is a recognized complication of respiratory virus infections, increasing morbidity and mortality, but can be readily treated if diagnosed early. An increasing number of small studies describing aspergillosis in coronavirus disease 2019 (COVID-19) patients with severe respiratory distress are being reported, but comprehensive data are lacking. The aim of this study was to determine the incidence, risk factors, and impact of invasive fungal disease in adult COVID-19 patients with severe respiratory distress.
methodsAn evaluation of a national, multicenter, prospective cohort evaluation of an enhanced testing strategy to diagnose invasive fungal disease in COVID-19 intensive care patients. Results were used to generate a mechanism to define aspergillosis in future COVID-19 patients.
resultsOne-hundred and thirty-five adults (median age: 57, M/F: 2.2/1) were screened. The incidence was 26.7% (14.1% aspergillosis, 12.6% yeast infections). The overall mortality rate was 38%; 53% and 31% in patients with and without fungal disease, respectively (P = .0387). The mortality rate was reduced by the use of antifungal therapy (mortality: 38.5% in patients receiving therapy vs 90% in patients not receiving therapy (P = .008). The use of corticosteroids (P = .007) and history of chronic respiratory disease (P = .05) increased the likelihood of aspergillosis.
conclusionsFungal disease occurs frequently in critically ill, mechanically ventilated COVID-19 patients. The survival benefit observed in patients receiving antifungal therapy implies that the proposed diagnostic and defining criteria are appropriate. Screening using a strategic diagnostic approach and antifungal prophylaxis of patients with risk factors will likely enhance the management of COVID-19 patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.