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ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1522217
This article is part of the Research Topic Advances in the Diagnosis and Management of Infectious Diseases View all 14 articles
Clinical Characteristics and Prognosis of COVID-19-Associated Invasive Pulmonary Aspergillosis in Critically Patients: A Single-Center Study
Provisionally accepted- 1 The First Affiliated Hospital of Soochow University, Suzhou, China
- 2 Qingdao Municipal Hospital, Qingdao, Shandong Province, China
Objective: A single-center retrospective study was conducted according to the latest diagnostic criteria of the European Consortium for Mycology in Medicine/International Society for Human and Animal Mycoses (ECMM/ISHAM) Consensus, which describes the clinical characteristics, factors influencing and prognosis of a group of patients with COVID-19 (Omicron variant) combined with invasive pulmonary mycoses with onset of disease at the end of 2022. Methods: This study retrospectively analyzed data related to 58 hospitalized patients with severe pneumonia due to COVID-19 infection. Our study compared the clinical and microbiological characteristics and associated risk factors of fungal infections and pulmonary fungal infections and performed univariate and multivariate analyses of factors associated with mortality in patients with COVID-19-Associated Pulmonary Aspergillosis (CAPA). Results: 17 of the 58 critically ill patients were diagnosed with CAPA. The difference in 60-day mortality outcomes between CAPA patients and non-CAPA patients was statistically significant. Diabetes mellitus, renal insufficiency, chronic obstructive pulmonary disease, elevated interleukin-6, mechanical ventilation, increased duration of steroids use, increased cumulative dose of steroids use, use of tocilizumab, and increased length of hospitalization in ICU, and increase in the type of antibiotics used were the risk factors for the occurrence of fungal infections. Conclusions: Patients with CAPA had a higher mortality rate, and their hospitalization was prolonged compared to non-CAPA patients. Through univariate and multivariate analyses of potential factors associated with mortality, we found that the use of mechanical ventilation, advanced age, and significantly elevated CRP levels predicted a worse prognosis. This study emphasized the importance of CAPA prevention strategies in managing COVID-19.
Keywords: COVID-19, Invasive Pulmonary Aspergillosis, Mortality, Influencing factors, Clinical Characteristics, Microbiological characteristics
Received: 04 Nov 2024; Accepted: 25 Mar 2025.
Copyright: © 2025 Xiao, Xu, Xiao, Li, Chen, Chen and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Weifeng Zhao, The First Affiliated Hospital of Soochow University, Suzhou, China
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