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Updated: Oct 2, 2025
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
COVID-19-Associated Pulmonary Aspergillosis in a Tertiary Hospital
García-Clemente Marta1, Forcelledo-Espina Lorena2, Martínez-Vega Laura1
1Pneumology Department, Central Universitary Hospital of Asturias (HUCA), 33011 Oviedo, Spain.
Abstract:
Our study aims to assess the prevalence of CAPA (COVID-19-associated pulmonary aspergillosis) and describe the associated risk factors and their impact on mortality. A prospective study was conducted. We included patients with COVID-19 disease who were admitted to the ICU with a diagnosis of respiratory failur. Mycological culture and other biomarkers (calcofluor staining, LFD, LFA, PCR, GM, and B-D-glucan) were performed. A total of 300 patients were included in the study. Thirty-five patients were diagnosed with CAPA (prevalence 11.7%). During admission, 57 patients died (19%), and, in the group of CAPA patients, mortality was 31.4%. In multivariate analysis, independent risk factors associated with CAPA diagnosis were age (OR: 1.05; 95% CI 1.01-1.09; p = 0.037), chronic lung disease (OR: 3.85; 95% CI 1.02-14.9; p = 0.049) and treatment with tocilizumab during admission (OR: 14.5; 95% 6.1-34.9; p = 0.001). Factors independently associated with mortality were age (OR: 1.06; 95% CI 1.01-1.11; p = 0.014) and CAPA diagnosis during admission (OR: 3.34; 95% CI 1.38-8.08; p = 0.007). CAPA is an infection that appears in many patients with COVID-19 disease. CAPA is associated with high mortality rates, which may be reduced by early diagnosis and initiation of appropriate antifungal therapy, so screening of COVID-19 ARDS (acute respiratory distress syndrome) patients for CAPA is essential.
Insights
COVID-19-associated pulmonary aspergillosis (CAPA) affects 11.7% of ICU patients with respiratory failure. Early diagnosis and antifungal treatment are crucial, as CAPA significantly increases mortality risk in these patients.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- COVID-19-associated pulmonary aspergillosis (CAPA) is a severe complication in critically ill patients.
- Understanding CAPA's prevalence, risk factors, and impact on mortality is essential for improving patient outcomes.
Purpose of the Study:
- To determine the prevalence of CAPA in intensive care unit (ICU) patients with COVID-19 and respiratory failure.
- To identify risk factors associated with CAPA development.
- To assess the impact of CAPA on mortality in this patient population.
Main Methods:
- A prospective study involving 300 ICU patients diagnosed with COVID-19 and respiratory failure.
- Diagnostic methods included mycological cultures and various biomarkers (e.g., PCR, GM, B-D-glucan).
- Multivariate analysis was used to identify independent risk factors for CAPA and mortality.
Main Results:
- The prevalence of CAPA was 11.7% (35 out of 300 patients).
- Independent risk factors for CAPA included older age, chronic lung disease, and tocilizumab treatment.
- CAPA diagnosis was independently associated with a 3.34-fold increased risk of mortality.
Conclusions:
- CAPA is a significant infection in COVID-19 patients, associated with a high mortality rate.
- Early screening and diagnosis of CAPA in COVID-19 patients with acute respiratory distress syndrome (ARDS) are critical.
- Prompt initiation of antifungal therapy may reduce CAPA-related mortality.
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