Coronavirus disease 19 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe fungal infection complicating critically ill COVID-19 patients. Numerous retrospective and prospective studies have been performed to get a better grasp on this lethal co-infection. We performed a qualitative review and summarized data from 48 studies in which 7047 patients had been included, of whom 820 had CAPA. The pooled incidence of proven, probable or putative CAPA was 15.1% among 2953 ICU-admitted COVID-19 patients included in 18 prospective studies. Incidences showed great variability due to multiple factors such as discrepancies in the rate and depth of the fungal work-up. The pathophysiology and risk factors for CAPA are ill-defined, but therapy with corticosteroids and anti-interleukin-6 therapy potentially confer the biggest risk. Sampling for mycological work-up using bronchoscopy is the cornerstone for diagnosis, as imaging is often aspecific. CAPA is associated with an increased mortality, but we do not have conclusive data whether therapy contributes to an increased survival in these patients. We conclude our review with a comparison between influenza-associated pulmonary aspergillosis (IAPA) and CAPA.
【저자키워드】 COVID-19, Critical care, Influenza, intensive care unit, aspergillosis, COVID-19-associated pulmonary aspergillosis (CAPA), influenza-associated pulmonary aspergillosis, IAPA, 【초록키워드】 Corticosteroid, therapy, Prospective Study, Diagnosis, risk, risk factor, Critically ill, pathophysiology, Patient, Co-infection, sampling, incidence, coronavirus disease 19, patients, fungal, COVID-19 patients, retrospective, COVID-19 patient, Fungal infection, Factor, Variability, increased survival, increased mortality, discrepancy, performed, contribute, aspecific, Numerous, 【제목키워드】 review, pulmonary, Visual, Comprehensive,