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Updated: Oct 8, 2025
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Invasive aspergillosis in coronavirus disease 2019: a practical approach for clinicians
1Infectious Diseases Service, Department of Medicine.
Purpose Of Review:
Invasive pulmonary aspergillosis (IPA) can affect patients with severe coronavirus disease 2019 (COVID-19), but many questions remain open about its very variable incidence across the world, the actual link between the viral infection and the fungal superinfection, the significance of Aspergillus recovery in a respiratory sample, and the management of such cases. This review addresses these questions and aims at providing some clues for the practical diagnostic and therapeutic approaches of COVID-19-associated pulmonary aspergillosis (CAPA) in a clinical perspective.
Recent Findings:
Definitions have been proposed for possible/probable/proven CAPA, but distinction between colonization and invasive fungal infection is difficult and not possible in most cases in the absence of histopathological proof or positive galactomannan in serum. Most importantly, the recovery of an Aspergillus by a direct (culture, PCR) or indirect (galactomannan) test in a respiratory sample is an indicator of worse outcome, which justifies a screening for early detection and initiation of preemptive antifungal therapy in such cases.
Summary:
The COVID-19 pandemic has increased our awareness of IPA among ICU patients. Although current recommendations are mainly based on experts' opinions, prospective studies are needed to get more evidence-based support for the diagnostic approach and management of CAPA.
Insights
Invasive pulmonary aspergillosis (IPA) is a serious concern in severe COVID-19 patients. Early screening and preemptive antifungal therapy are crucial due to worse outcomes associated with Aspergillus detection.
Area of Science:
- Pulmonology
- Infectious Diseases
- Mycology
Background:
- Severe COVID-19 patients are susceptible to invasive pulmonary aspergillosis (IPA).
- The incidence, pathogenesis, and management of COVID-19-associated pulmonary aspergillosis (CAPA) remain incompletely understood.
- The COVID-19 pandemic has heightened awareness of IPA in intensive care unit (ICU) settings.
Purpose of the Study:
- To review diagnostic and therapeutic strategies for CAPA.
- To address uncertainties regarding CAPA incidence, viral-fungal interactions, and Aspergillus significance.
- To provide clinical guidance for managing CAPA.
Main Methods:
- Review of current literature and expert opinions.
- Analysis of diagnostic challenges, including distinguishing colonization from infection.
- Discussion of screening, early detection, and preemptive antifungal therapy.
Main Results:
- Distinguishing fungal colonization from invasive infection in CAPA is challenging without histopathology or serum galactomannan.
- Aspergillus detection in respiratory samples indicates a poorer prognosis.
- Screening and preemptive antifungal treatment are recommended for early detection and improved outcomes.
Conclusions:
- Current CAPA recommendations rely heavily on expert consensus.
- Further prospective studies are essential to establish evidence-based diagnostic and management guidelines.
- Increased vigilance and proactive management are necessary for CAPA patients.
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