ArticleCritical care (London, England)2022
Corticosteroids as risk factor for COVID-19-associated pulmonary aspergillosis in intensive care patients.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 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
- The association between inhaled corticosteroid and the risks of SARS-COV-2 infection: A systematic review and meta-analysis.Journal of infection and public health · 2023Pooled it
- Article
- Risk factors for intensive care unit coronavirus disease 2019 pneumonia-associated invasive fungal infections: a Bayesian evidence synthesis integrating external and real-world data.Virology journal · 2026Article
- Diagnostic Performance of Sōna GM LFA in Pulmonary Infections Caused by Different Aspergillus Species.Mycoses · 2026Article
- Diagnostic performance ofJournal of thoracic disease · 2025Article
- Mycobiome analyses of critically ill COVID-19 patients.Microbiology spectrum · 2025Article
- Safety of steroids in severe community-acquired pneumonia.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Pulmonary aspergillosis in US Veterans with COVID-19: a nationwide, retrospective cohort study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Impact of the COVID-19 Pandemic on Inpatient Antibiotic and Antifungal Drug Prescribing Volumes in Germany.Antibiotics (Basel, Switzerland) · 2024Article
- Predicting COVID 19-Associated Pulmonary Aspergillosis Risk in Low- and Middle-Income Countries: A Matched Case-Control Study.Open forum infectious diseases · 2024Article
- In-hospital survival of critically ill COVID-19 patients treated with glucocorticoids: a multicenter real-world data study.Scientific reports · 2024Article
- Invasive pulmonary aspergillosis among patients with severe community-acquired pneumonia and influenza in ICUs: a retrospective cohort study.Pneumonia (Nathan Qld.) · 2024Article
- High Burden of COVID-19-Associated Pulmonary Aspergillosis in Severely Immunocompromised Patients Requiring Mechanical Ventilation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Observational
- COVID-19-associated pulmonary aspergillosis in intensive care unit: A real-life experience.Heliyon · 2024Article
- A prediction model for secondary invasive fungal infection among severe SARS-CoV-2 positive patients in ICU.Frontiers in cellular and infection microbiology · 2024Article
- COVID-19-associated pulmonary aspergillosis in mechanically ventilated patients: a prospective, multicentre UK study.Thorax · 2023Article
- Theory and Practice of Glucocorticoids in COVID-19: Getting to the Heart of the Matter-A Critical Review and Viewpoints.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Mortality in ICU Patients with COVID-19-Associated Pulmonary Aspergillosis.Journal of fungi (Basel, Switzerland) · 2023Review
- Fungal Infections in the ICU during the COVID-19 Pandemic in Mexico.Journal of fungi (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCorticosteroids, in particular dexamethasone, are one of the primary treatment options for critically ill COVID-19 patients. However, there are a growing number of cases that involve COVID-19-associated pulmonary aspergillosis (CAPA), and it is unclear whether dexamethasone represents a risk factor for CAPA. Our aim was to investigate a possible association of the recommended dexamethasone therapy with a risk of CAPA.
methodsWe performed a study based on a cohort of COVID-19 patients treated in 2020 in our 13 intensive care units at Charité Universitätsmedizin Berlin. We used ECMM/ISHM criteria for the CAPA diagnosis and performed univariate and multivariable analyses of clinical parameters to identify risk factors that could result in a diagnosis of CAPA.
resultsAltogether, among the n = 522 intensive care patients analyzed, n = 47 (9%) patients developed CAPA. CAPA patients had a higher simplified acute physiology score (SAPS) (64 vs. 53, p < 0.001) and higher levels of IL-6 (1,005 vs. 461, p < 0.008). They more often had severe acute respiratory distress syndrome (ARDS) (60% vs. 41%, p = 0.024), renal replacement therapy (60% vs. 41%, p = 0.024), and they were more likely to die (64% vs. 48%, p = 0.049). The multivariable analysis showed dexamethasone (OR 3.110, CI95 1.112-8.697) and SAPS (OR 1.063, CI95 1.028-1.098) to be independent risk factors for CAPA.
conclusionIn our study, dexamethasone therapy as recommended for COVID-19 was associated with a significant three times increase in the risk of CAPA.
trial registrationRegistration number DRKS00024578, Date of registration March 3rd, 2021.
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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.