The aim of this study was to describe the frequency of positive Aspergillus tests in COVID-19 patients and investigate the association between COVID-19 and a positive Aspergillus test result. We compared the proportion of positive Aspergillus tests in COVID-19 patients admitted to the intensive care unit (ICU) for >24 h with two control groups: patients with community-acquired pneumonia with (i) a PCR-confirmed influenza infection (considered a positive control since the link between influenza and invasive aspergillosis has been established) and (ii) Streptococcus pneumoniae pneumonia (in whom positive Aspergillus tests are mostly considered as colonization). During the study period, 92 COVID-19 patients (mean [standard deviation] age, 62 [14] years; 76.1% males), 48 influenza patients (55 [14]; 56.2% males), and 65 pneumococcal pneumonia patients (58 [15], 63,1% males) were identified. Any positive Aspergillus test from any respiratory sample was found in 10.9% of the COVID-19 patients, 6.2% of the patients with pneumococcal pneumonia, and 22.9% of those infected with influenza. A positive culture or PCR or galactomannan test on bronchoalveolar lavage (BAL) fluid only was found in 5.4% of COVID-19 patients, which was lower than in patients with influenza (18.8%) and comparable to that in the pneumococcal pneumonia group (4.6%). Using logistic regression analysis, the odds ratio (OR) (95% confidence interval) for a positive Aspergillus test on BAL fluid for COVID-19 patients was 1.2 (0.3 to 5.1; P = 0.8) compared to the pneumococcal pneumonia group, while it was 0.2 (0.1 to 0.8; P = 0.02) compared to the influenza group. This difference remained significant when corrected for age and sex. In conclusion, in COVID-19 patients, the prevalence of a positive Aspergillus test was comparable to that in patients admitted for pneumococcal pneumonia but substantially lower than what we observed in patients with influenza.

中文翻译：

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与其他进入重症监护病房的肺部感染患者相比，COVID-19患者中曲霉菌阳性检测的频率

这项研究的目的是描述COVID-19患者中曲霉菌阳性检测的频率，并研究COVID-19与曲霉菌阳性检测结果之间的关联。我们将接受重症监护病房（ICU）24小时以上的COVID-19患者与两个对照组的曲霉菌试验阳性率进行了比较：两个社区获得性肺炎患者（i）PCR确诊的流感感染（认为由于已经建立了流感和侵袭性曲霉病之间的联系，因此具有阳性对照）和（ii）肺炎链球菌肺炎（其中曲霉菌呈阳性）测试通常被认为是殖民化）。在研究期间，有92名COVID-19患者（平均[标准差]年龄，62 [14]岁；男性76.1％），48例流感患者（55 [14]； 56.2％男性）和65例肺炎球菌性肺炎患者（58岁） [15]，发现了63,1％的男性。任何阳性曲霉在10.9％的COVID-19患者，6.2％的肺炎球菌性肺炎患者和22.9％的流感感染者中，从任何呼吸道样本中均检测到了这种病毒。仅在5.4％的COVID-19患者中发现支气管肺泡灌洗液（BAL）呈阳性培养或PCR或半乳甘露聚糖试验，低于流感患者（18.8％），与肺炎球菌肺炎组的患者相当（4.6） ％）。使用logistic回归分析，与肺炎球菌肺炎组相比，COVID-19患者BAL液曲霉菌试验阳性的比值比（OR）（95％置信区间）为1.2（0.3至5.1; P = 0.8）为0.2（0.1至0.8；P= 0.02）与流感组相比。校正年龄和性别后，这种差异仍然很明显。总之，在COVID-19患者中，曲霉菌试验阳性的发生率与肺炎球菌肺炎住院患者的发生率相当，但大大低于我们在流感患者中观察到的发生率。