ArticleThorax2023
COVID-19-associated pulmonary aspergillosis in mechanically ventilated patients: a prospective, multicentre UK study.
Article in Thorax, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 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
- Age difference of patients with and without invasive aspergillosis: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- 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
- Invasive pulmonary aspergillosis among ICU patients with COVID-19, influenza, and preexisting host factors: a nationwide cohort study.BMC infectious diseases · 2026Article
- Concurrent pretreatment serum and BALF galactomannan positivity as a prognostic indicator in non-neutropenic invasive pulmonary aspergillosis without malignancy or solid organ transplantation: a retrospective cohort study.Frontiers in medicine · 2026Article
- Detection ofFrontiers in cellular and infection microbiology · 2026Article
- The Prognostic Value of (1→3)-β-D-Glucan in COVID-19 Patients with and Without Secondary Fungal Disease.Journal of fungi (Basel, Switzerland) · 2025Article
- Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study.Tropical medicine and infectious disease · 2025Article
- [S1 guideline: diagnosis and treatment of invasive pulmonary aspergillosis in critically ill/intensive care patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Pentraxin-3 as a novel prognostic biomarker in non-neutropenic invasive pulmonary aspergillosis patients.Microbiology spectrum · 2025Article
- Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case.The American journal of case reports · 2025Article
- Epidemiology of Coronavirus Disease 2019-Associated Fungal Infections in the Intensive Care Unit: A Single-Center Retrospective Study.Mycopathologia · 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
- The Value of the Galactomannan Test in Diagnosing COVID-19-Associated Pulmonary Aspergillosis: A Review.Iranian journal of pathology · 2025Review
- Epidemiology, clinical and biological characteristics, and prognosis of critically ill COVID 19 patients: a single-center experience through 4 successive waves.Pneumonia (Nathan Qld.) · 2024Article
- Invasive Fungal Infections in Immunocompromised Conditions: Emphasis on COVID-19.Current microbiology · 2024Review
- Predicting COVID 19-Associated Pulmonary Aspergillosis Risk in Low- and Middle-Income Countries: A Matched Case-Control Study.Open forum infectious diseases · 2024Article
- COVID-19 associated pulmonary aspergillosis in critically-ill patients: a prospective multicenter study in the era of Delta and Omicron variants.Annals of intensive care · 2024Article
- Risk factors for COVID-19 associated pulmonary aspergillosis and outcomes in patients with acute respiratory failure in a respiratory sub-intensive care unit.BMC infectious diseases · 2024Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundInvasive pulmonary aspergillosis is a complication of severe COVID-19, with regional variation in reported incidence and mortality. We describe the incidence, risk factors and mortality associated with COVID-19-associated pulmonary aspergillosis (CAPA) in a prospective, multicentre UK cohort.
methodsFrom March 2020 to March 2021, 266 mechanically ventilated adults with COVID-19 were enrolled across 5 UK hospital intensive care units (ICUs). CAPA was defined using European Confederation for Medical Mycology and the International Society for Human and Animal Mycology criteria and fungal diagnostics performed on respiratory and serum samples.
resultsTwenty-nine of 266 patients (10.9%) had probable CAPA, 14 (5.2%) possible CAPA and none proven CAPA. Probable CAPA was diagnosed a median of 9 (IQR 7-16) days after ICU admission. Factors associated with probable CAPA after multivariable logistic regression were cumulative steroid dose given within 28 days prior to ICU admission (adjusted OR (aOR) 1.16; 95% CI 1.01 to 1.43 per 100 mg prednisolone-equivalent), receipt of an interleukin (IL)-6 inhibitor (aOR 2.79; 95% CI 1.22 to 6.48) and chronic obstructive pulmonary disease (COPD) (aOR 4.78; 95% CI 1.13 to 18.13). Mortality in patients with probable CAPA was 55%, vs 46% in those without. After adjustment for immortal time bias, CAPA was associated with an increased risk of 90-day mortality (HR 1.85; 95% CI 1.07 to 3.19); however, this association did not remain statistically significant after further adjustment for confounders (adjusted HR 1.57; 95% CI 0.88 to 2.80). There was no difference in mortality between patients with CAPA prescribed antifungals (9 of 17; 53%) and those who were not (7 of 12; 58%) (p=0.77).
interpretationIn this first prospective UK study, probable CAPA was associated with corticosteroid use, receipt of IL-6 inhibitors and pre-existing COPD. CAPA did not impact mortality following adjustment for prognostic variables.
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