ArticleInfluenza and other respiratory viruses2023
Higher risk for influenza-associated pulmonary aspergillosis (IAPA) in asthmatic patients: A Swiss multicenter cohort study on IAPA in critically ill influenza patients.
Article in Influenza and other respiratory viruses, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Guideline
- Invasive aspergillosis in critically ill patients with diabetes mellitus: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Age difference of patients with and without invasive aspergillosis: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Incidence and outcomes of influenza-associated pulmonary aspergillosis and the role of antifungal prophylaxis: a structured literature review.Critical care (London, England) · 2026Review
- Secondary fungal infections in severe acute viral diseases: clinical features and underlying immune mechanisms.Frontiers in microbiology · 2026Review
- Influenza-associated invasive aspergillosis in the ICU: a prospective, multicentre cohort study.Critical care (London, England) · 2025Observational
- Influenza-related invasive pulmonary aspergillosis in an infectious disease ward at a pulmonary referral center in Iran.BMC infectious diseases · 2025Article
- Pulmonary Aspergillosis in Immunocompromised Critically Ill Patients: Prevalence, Risk Factors, Clinical Features and Diagnosis-A Narrative Review.Journal of fungi (Basel, Switzerland) · 2025Review
- Monitoring the Occurrence ofMicroorganisms · 2025Article
- Invasive Aspergillosis in the Intensive Care Unit.Journal of fungi (Basel, Switzerland) · 2025Review
- Viral reactivations and fungal infections in nonresolving acute respiratory distress syndrome.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Higher risk for influenza-associated pulmonary aspergillosis (IAPA) in asthmatic patients: A Swiss multicenter cohort study on IAPA in critically ill influenza patients.Influenza and other respiratory viruses · 2023Article
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Authors and funding
17 authors at 10 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfluenza-associated pulmonary aspergillosis (IAPA) is an important complication of severe influenza with high morbidity and mortality.
methodsWe conducted a retrospective multicenter study in tertiary hospitals in Switzerland during 2017/2018 and 2019/2020 influenza seasons. All adults with PCR-confirmed influenza infection and treatment on intensive-care unit (ICU) for >24 h were included. IAPA was diagnosed according to previously published clinical, radiological, and microbiological criteria. We assessed risk factors for IAPA and predictors for poor outcome, which was a composite of in-hospital mortality, ICU length of stay ≥7 days, mechanical ventilation ≥7 days, or extracorporeal membrane oxygenation.
resultsOne hundred fifty-eight patients (median age 64 years, 45% females) with influenza were included, of which 17 (10.8%) had IAPA. Asthma was more common in IAPA patients (17% vs. 4% in non-IAPA, P = 0.05). Asthma (OR 12.0 [95% CI 2.1-67.2]) and days of mechanical ventilation (OR 1.1 [1.1-1.2]) were associated with IAPA. IAPA patients frequently required organ supportive therapies including mechanical ventilation (88% in IAPA vs. 53% in non-IAPA, P = 0.001) and vasoactive support (75% vs. 45%, P = 0.03) and had more complications including ARDS (53% vs. 26%, P = 0.04), respiratory bacterial infections (65% vs. 37%, P = 0.04), and higher ICU-mortality (35% vs. 16.4%, P = 0.05). IAPA (OR 28.8 [3.3-253.4]), influenza A (OR 3.3 [1.4-7.8]), and higher SAPS II score (OR 1.07 [1.05-1.10]) were independent predictors of poor outcome.
interpretationHigh clinical suspicion, early diagnostics, and therapy are indicated in IAPA because of high morbidity and mortality. Asthma is likely an underappreciated risk factor for IAPA.
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