COVID-19-associated pulmonary aspergillosis in mechanically ventilated patients: a deadly complication

Despite effectiveness of broad-spectrum antifungal prophylaxis in those at highest risk,1 prevalence of invasive pulmonary aspergillosis continues to increase as it becomes increasingly recognised in non-immunosuppressed individuals, including those in the intensive care unit (ICU) with severe respiratory viral infection such as COVID-19.2–4 COVID-19-associated pulmonary aspergillosis (CAPA) has emerged as an important and deadly complication,5 6 triggered by specific immunological mechanisms including suppression of the type I interferon response,3 as well as depletion of B cells and consequently anti-Aspergillus fumigatus IgG7 predisposing to tissue invasion and invasive infection. As CAPA is difficult to diagnose, with conventional diagnostics from blood-lacking sensitivity,8 9 reported incidence rates varied widely depending strongly on how aggressive diagnostics from specimens of the respiratory tract were implemented and characteristics of the COVID-19 ICU population, including age.
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Thorax, COVID-19 Editorial Source Type: research