Background/Purpose
Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is common in critically ill patients with COVID-19 and is associated with worse outcomes. However, reports on CAPA and its impact on treatment outcomes in Asian populations are limited.
Methods
Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction-confirmed COVID-19 admitted to intensive care units (ICUs) were retrospectively enrolled in this observational study. The incidence rate of CAPA during ICU admission was investigated. The clinical factors associated with CAPA, including corticosteroid exposure, were analyzed. The impact of CAPA on the treatment outcomes and SARS-CoV-2 viral shedding were explored.
Results
A total of 72 ICU-admitted patients with COVID-19 were included in the analysis. The incidence rate of CAPA was 15.3% (11/72) in all patients and 23% (11/48) in the mechanically ventilated patients. The median time from ICU admission to CAPA diagnosis was 15 days. A lower fibrinogen level (adjusted odds ratio [aOR], 0.983; 95% confidence interval [CI], 0.967–0.999) was independently associated with CAPA. The patients with CAPA had a higher in-hospital mortality rate (55% vs. 13%, p = 0.001) and a longer SARS-CoV-2 viral shedding time (22 days vs. 16 days, p = 0.037) than those without CAPA.
Conclusion
Lower serum fibrinogen levels was independently associated with CAPA among the ICU-admitted patients with COVID-19. The patients with CAPA had a higher in-hospital mortality rate and a longer SARS-CoV-2 viral shedding time than those without CAPA.
【저자키워드】 Corticosteroid, COVID-19, Virus shedding, Aspergillus, CAPA, 【초록키워드】 SARS-CoV-2, Coronavirus disease 2019, coronavirus, Treatment outcome, intensive care unit, Diagnosis, mechanically ventilated patients, Population, outcomes, serum, Patient, ICU admission, incidence rate, fibrinogen, reverse transcription, Analysis, Critically ill patient, Asian, acute respiratory syndrome, adjusted odds ratio, 95% confidence interval, in-hospital mortality rate, median time, ICUs, SARS-CoV-2 viral shedding, Lower, polymerase chain, Result, enrolled, analyzed, investigated, clinical factor, fibrinogen level, patients with COVID-19, with COVID-19, 【제목키워드】 in-hospital mortality, SARS-CoV-2 viral shedding,