Clinical Features and Predictive Risk Factors for Prognosis in Invasive Pulmonary Aspergillosis and Pulmonary...

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Invasive pulmonary aspergillosis (IPA) and pulmonary mucormycosis (PM) are leading invasive mold lung infections with increasing incidence.
• Similarities in patient populations and imaging characteristics complicate differential diagnosis, potentially leading to treatment errors.
• Early diagnosis and identification of severe cases are critical clinical challenges.

Purpose of the Study:

• To compare clinical characteristics, laboratory findings, and radiological features of IPA and PM.
• To assess and compare the prognosis of patients with IPA and PM.
• To identify independent risk factors for poor prognosis and evaluate novel assessment tools.

Main Methods:

• Retrospective cohort study of IPA and PM patients (2017-2022).
• Analysis of clinical data, laboratory parameters, and chest radiology.
• Prognostic classification and identification of independent risk factors for adverse outcomes.

Main Results:

• PM patients were younger, with higher rates of diabetes and solid organ transplantation compared to IPA.
• Consolidation and bronchial stenosis were more common in PM; pathological confirmation was more frequent.
• No significant differences in ICU stay, mechanical ventilation, or 90-day mortality between PM and IPA.
• Post-influenza infection and NLR were risk factors for ICU stay; post-influenza infection and HbA1c for mechanical ventilation.

Conclusions:

• PM and IPA patients share significant clinical and prognostic similarities, including high 90-day mortality and ICU utilization.
• Neutrophil-to-lymphocyte ratio (NLR) and hemoglobin A1c (HbA1c) levels are independent risk factors for adverse outcomes.
• Combining NLR and HbA1c with existing tools enhances prognostic accuracy for invasive pulmonary mold infections, particularly during influenza seasons.