Invasive pulmonary aspergillosis (IPA) is a severe infection caused by aspergillus sp. that usually develops in patients with severe immunosuppression. IPA has been recently described in critically ill COVID-19 patients (termed as COVID-associated pulmonary aspergillosis, or CAPA) that are otherwise immunocompetent. In order to describe the characteristics of patients with CAPA, we conducted a retrospective cohort study in a tertiary care center in Mexico City. We included all patients with confirmed COVID-19 admitted to the intensive care unit that had serum or bronchoalveolar lavage galactomannan measurements. We used the criteria proposed by Koehler et al. to establish the diagnosis of CAPA. Main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital mortality. Out of a total of 83 hospitalized patients with COVID-19 in the ICU, 16 (19.3%) met the criteria for CAPA. All patients diagnosed with CAPA required IMV whereas only 84% of the patients in the non-IPA group needed this intervention (P = 0.09). In the IPA group, 31% (n = 5) of the patients died, compared to 13% (n = 9) in the non-CAPA group (P = 0.08). We conclude that CAPA is a frequent co-infection in critically ill COVID-19 patients and is associated with a high mortality rate. The timely diagnosis and treatment of IPA in these patients is likely to improve their outcome. LAY SUMMARY We studied the characteristics of patients with COVID-19-associated invasive pulmonary aspergillosis (CAPA). Patients with CAPA tended to need invasive mechanical ventilation more frequently and to have a higher mortality rate. Adequate resources for its management can improve their outcome.

中文翻译：

---

墨西哥城三级护理中心中与COVID-19相关的浸润性肺曲霉病。

侵袭性肺曲霉病（IPA）是由曲霉菌sp引起的严重感染。通常在严重免疫抑制的患者中发展。IPA最近在重症COVID-19患者（称为COVID相关性肺曲霉病或CAPA）中具有免疫原性，已被描述。为了描述CAPA患者的特征，我们在墨西哥城的三级医疗中心进行了一项回顾性队列研究。我们纳入了所有接受确诊为重症监护病房且血清或支气管肺泡灌洗半乳甘露聚糖测定为COVID-19的患者。我们使用了Koehler等人提出的标准。建立CAPA的诊断。主要结果是需要有创机械通气（IMV）和住院死亡率。在ICU的83例住院的COVID-19住院患者中，有16例（19.3％）符合CAPA的标准。所有被诊断为CAPA的患者都需要IMV，而非IPA组中只有84％的患者需要这种干预（P = 0.09）。在IPA组中，有31％（n = 5）的患者死亡，而在非CAPA组中则有13％（n = 9）的患者死亡（P = 0.08）。我们得出的结论是，CAPA是重症COVID-19患者的常见合并感染，并与高死亡率相关。在这些患者中及时诊断和治疗IPA可能会改善其预后。内容提要我们研究了COVID-19相关性浸润性肺曲霉病（CAPA）患者的特征。CAPA患者倾向于更频繁地需要有创机械通气，并且死亡率更高。