Bacterial or virus co-infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in many studies, however, the knowledge on Aspergillus co-infection among patients with coronavirus disease 2019 (COVID-19) was limited. This literature review aims to explore and describe the updated information about COVID-19 associated with pulmonary aspergillosis. We found that Aspergillus spp. can cause co-infections in patients with COVID-19, especially in severe/critical illness. The incidence of IPA in COVID-19 ranged from 19.6% to 33.3%. Acute respiratory distress syndrome requiring mechanical ventilation was the common complications, and the overall mortality was high, which could be up to 64.7% (n = 22) in the pooled analysis of 34 reported cases. The conventional risk factors of invasive aspergillosis were not common among these specific populations. Fungus culture and galactomannan test, especially from respiratory specimens could help early diagnosis. Aspergillus fumigatus was the most common species causing co-infection in COVID-19 patients, followed by Aspergillus flavus. Although voriconazole is the recommended anti-Aspergillus agent and also the most commonly used antifungal agent, aspergillosis caused by azole-resistant Aspergillus is also possible. Additionally, voriconazole should be used carefully in the concern of complicated drug–drug interaction and enhancing cardiovascular toxicity on anti-SARS-CoV-2 agents. Finally, this review suggests that clinicians should keep alerting the possible occurrence of pulmonary aspergillosis in severe/critical COVID-19 patients, and aggressively microbiologic study in addition to SARS-CoV-2 via respiratory specimens should be indicated.

许多研究报告了严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 的细菌或病毒合并感染，但是，关于 2019 冠状病毒病 (COVID-19) 患者曲霉菌合并感染的知识有限。本文献综述旨在探索和描述与肺曲霉病相关的 COVID-19 的最新信息。我们发现曲霉属。可能导致 COVID-19 患者合并感染，尤其是重症/危重症患者。COVID-19 中 IPA 的发生率为 19.6% 至 33.3%。需要机械通气的急性呼吸窘迫综合征是常见并发症，总体死亡率高，可达64.7%（n = 22) 在对 34 例报告病例的汇总分析中。侵袭性曲霉病的传统危险因素在这些特定人群中并不常见。真菌培养和半乳甘露聚糖试验，尤其是呼吸道标本，有助于早期诊断。烟曲霉是导致 COVID-19 患者合并感染的最常见菌种，其次是黄曲霉。虽然伏立康唑是推荐的抗曲霉菌药物，也是最常用的抗真菌药物，但由耐唑类曲霉菌引起的曲霉菌病也是可以的。此外，考虑到复杂的药物相互作用和增强抗 SARS-CoV-2 药物的心血管毒性，应谨慎使用伏立康唑。最后，这篇综述建议临床医生应不断警惕重症/危重 COVID-19 患者可能发生肺曲霉菌病，并且除了通过呼吸道标本进行 SARS-CoV-2 外，还应进行积极的微生物学研究。