Invasive pulmonary aspergillosis (IPA) in intensive care unit patients is a major concern. Influenza-associated acute respiratory distress syndrome (ARDS) and severe COVID-19 patients are both at risk of developing invasive fungal diseases. We used the new international definitions of influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) to compare the demographic, clinical, biological, and radiological aspects of IAPA and CAPA in a monocentric retrospective study. A total of 120 patients were included, 71 with influenza and 49 with COVID-19-associated ARDS. Among them, 27 fulfilled the newly published criteria of IPA: 17/71 IAPA (23.9%) and 10/49 CAPA (20.4%). Kaplan–Meier curves showed significantly higher 90-day mortality for IPA patients overall ( p = 0.032), whereas mortality did not differ between CAPA and IAPA patients. Radiological findings showed differences between IAPA and CAPA, with a higher proportion of features suggestive of IPA during IAPA. Lastly, a wide proportion of IPA patients had low plasma voriconazole concentrations with a higher delay to reach concentrations > 2 mg/L in CAPA vs. IAPA patients ( p = 0.045). Severe COVID-19 and influenza patients appeared very similar in terms of prevalence of IPA and outcome. The dramatic consequences on the patients’ prognosis emphasize the need for a better awareness in these particular populations.
【저자키워드】 COVID-19, Corticosteroids, acute respiratory distress syndrome, Influenza, CT-scan, CAPA, pulmonary aspergillosis, Therapeutic Drug Monitoring, IAPA, voriconazole, 【초록키워드】 ARDS, Diseases, Mortality, intensive care, Prognosis, risk, outcome, Prevalence, Retrospective study, International, Patient, plasma, patients, fungal, acute respiratory distress, Concentration, Invasive pulmonary aspergillosis, criteria, syndrome, Kaplan–Meier, populations, IPA, feature, consequence, invasive, radiological, COVID-19-associated ARDS, not differ, proportion, significantly higher, severe COVID-19 patient, 【제목키워드】 pulmonary,