Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
High Burden of COVID-19-Associated Pulmonary Aspergillosis in Severely Immunocompromised Patients Requiring Mechanical Ventilation.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 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
- Guideline
- Age difference of patients with and without invasive aspergillosis: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Invasive Aspergillosis Complicating Severe COVID-19: Cumulative Incidence, Risk Factors, and Outcomes Between the First Wave of the Pandemic and Subsequent Waves, According to the ECMM/ISHAM Classification and a Local Case Assessment.Journal of fungi (Basel, Switzerland) · 2026Article
- 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
- Article
- Diagnostic Performance of Sōna GM LFA in Pulmonary Infections Caused by Different Aspergillus Species.Mycoses · 2026Article
- COVID-19-associated Pulmonary Aspergillosis in Mechanically Ventilated Patients at 7 US Hospitals: Epidemiology and Estimated Likelihood of Invasive Pulmonary Aspergillosis-Results of the Prospective MSG-017 Study.Open forum infectious diseases · 2025Article
- Real-World Experience with Isavuconazole for Invasive Aspergillosis in Hematologic Patients with and Without COVID-19 in Brazil.Journal of fungi (Basel, Switzerland) · 2025Article
- Article
- Explainable machine learning model for prediction of 28-day all-cause mortality in immunocompromised patients in the intensive care unit: a retrospective cohort study based on MIMIC-IV database.European journal of medical research · 2025Article
- Comparison of Patients With or Without COVID-19 and Without Hematological Diseases Treated for Invasive Pulmonary Aspergillosis: A 5-Year Retrospective Cohort Study with Propensity-Based Adjustment.Open forum infectious diseases · 2025Article
- Towards a holistic approach to pulmonary infections. Insights from the Sixth Annual Meeting of Spanish Experts 2024.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case.The American journal of case reports · 2025Article
- Article
- Profiling Bacteria in the Lungs of Patients with Severe Influenza Versus COVID-19 with or without Aspergillosis.American journal of respiratory and critical care medicine · 2024Article
- Fungal lung disease.The European respiratory journal · 2024Review
- Does early combination vs. Monotherapy improve clinical outcomes of clinically extremely vulnerable patients with COVID-19? Results from a retrospective propensity-weighted analysis.European journal of medical research · 2024Article
- Factors affecting mortality in COVID-19-associated pulmonary aspergillosis: An international ID-IRI study.Heliyon · 2024Article
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Authors and funding
19 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundCoronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a frequent superinfection in critically ill patients with COVID-19 and is associated with increased mortality rates. The increasing proportion of severely immunocompromised patients with COVID-19 who require mechanical ventilation warrants research into the incidence and impact of CAPA during the vaccination era.
methodsWe performed a retrospective, monocentric, observational study. We collected data from adult patients with severe COVID-19 requiring mechanical ventilation who were admitted to the intensive care unit (ICU) of University Hospitals Leuven, a tertiary referral center, between 1 March 2020 and 14 November 2022. Probable or proven CAPA was diagnosed according to the 2020 European Confederation for Medical Mycology/International Society for Human and Animal Mycology (ECMM/ISHAM) criteria.
resultsWe included 335 patients. Bronchoalveolar lavage sampling was performed in 300 (90%), and CAPA was diagnosed in 112 (33%). The incidence of CAPA was 62% (50 of 81 patients) in European Organisation for Research and Treatment of Cancer (EORTC)/Mycosis Study Group Education and Research Consortium (MSGERC) host factor-positive patients, compared with 24% (62 of 254) in host factor-negative patients. The incidence of CAPA was significantly higher in the vaccination era, increasing from 24% (57 of 241) in patients admitted to the ICU before October 2021 to 59% (55 of 94) in those admitted since then. Both EORTC/MSGERC host factors and ICU admission in the vaccination era were independently associated with CAPA development. CAPA remained an independent risk factor associated with mortality risk during the vaccination era.
conclusionsThe presence of EORTC/MSGERC host factors for invasive mold disease is associated with increased CAPA incidence and worse outcome parameters, and it is the main driver for the significantly higher incidence of CAPA in the vaccination era. Our findings warrant investigation of antifungal prophylaxis in critically ill patients with COVID-19.
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