Mortality in ICU Patients with COVID-19-Associated Pulmonary Aspergillosis

Abstract

A review of 38 studies involving 1437 COVID-19 patients admitted to intensive care units (ICUs) with pulmonary aspergillosis (CAPA) was conducted to investigate whether mortality has improved since the pandemic’s onset. The study found that the median ICU mortality was 56.8%, ranging from 30% to 91.8%. These rates were higher for patients admitted during 2020–2021 (61.4%) compared to 2020 (52.3%), and prospective studies found higher ICU mortality (64.7%) than retrospective ones (56.4%). The studies were conducted in various countries and used different criteria to define CAPA. The percentage of patients who received antifungal therapy varied across studies. These results indicate that the mortality rate among CAPA patients is a growing concern, mainly since there has been an overall reduction in mortality among COVID-19 patients. Urgent action is needed to improve prevention and management strategies for CAPA, and additional research is needed to identify optimal treatment strategies to reduce mortality rates among these patients. This study serves as a call to action for healthcare professionals and policymakers to prioritize CAPA, a serious and potentially life-threatening complication of COVID-19.

Risk factors for COVID-19 associated pulmonary aspergillosis and outcomes in patients with acute respiratory failure in a respiratory sub-intensive care unit

“…Incidence rates may vary from 5 to 40% across different geographic regions, with higher rates observed in patients requiring mechanical ventilation [ 8 ]. CAPA is a life-threatening condition, with high mortality rates, usually exceeding 40–60% even with appropriate antifungal treatment [ 7 , 9 – 11 ]. Previously reported risk factors included age, chronic respiratory diseases, chronic renal failure, chronic corticosteroid use, neutropenia, lymphopenia, severe COVID-19 requiring mechanical ventilation and tocilizumab administration [ 7 , 8 , 12 – 16 ].…”

Factors affecting mortality in COVID-19-associated pulmonary aspergillosis: An international ID-IRI study

“…The prevalence of CAPA among patients in the intensive care unit (ICU) is approximately 10 %, and the mortality rate is high [ 8 , 9 ]. Numerous studies have investigated the risk factors for CAPA development and the impact of CAPA on mortality by comparing patients with COVID-19 with and without IPA [ [10] , [11] , [12] , [13] , [14] , [15] ].…”