Pulmonary aspergillosis has been reported at high rates in patients with coronavirus disease 2019 (COVID-19) and is associated with high morbidity and mortality. We retrospectively assessed all patients admitted to an intensive care unit during the early COVID-19 surge (3/17/20–5/10/20) at our medical center in the midwestern USA for the presence of COVID-19-associated pulmonary aspergillosis (CAPA). Patients were not routinely screened for CAPA; diagnostic work-up for fungal infections was pursued when clinically indicated. Among 256 patients admitted to the ICU with severe COVID-19, 188 (73%) were intubated and 62 (24%) ultimately expired within 30 days of admission to the ICU. Only three patients (1%) were found to have CAPA; diagnosis was made by tracheal aspirate cultures in two cases and by bronchoalveolar lavage fluid Aspergillus galactomannan in one case. None of the patients who developed CAPA had classic risk factors for invasive fungal infection. The occurrence of CAPA was much lower than that reported at other centers, likely reflecting the local epidemiology.

据报道，2019 年冠状病毒病 (COVID-19) 患者中肺曲霉病的发病率很高，并且与高发病率和死亡率相关。我们回顾性评估了美国中西部医疗中心在早期 COVID-19 激增期间（20 年 3 月 17 日至 20 年 10 月 10 日）入住重症监护室的所有患者是否存在与 COVID-19 相关的肺曲霉病（卡帕）。患者没有接受 CAPA 常规筛查；当有临床指征时，进行真菌感染的诊断检查。在 ICU 收治的 256 名重症 COVID-19 患者中，188 名患者（73%）接受了插管，62 名患者（24%）最终在入住 ICU 后 30 天内死亡。仅 3 名患者 (1%) 被发现患有 CAPA； 2 例通过气管抽吸培养物诊断，1 例通过支气管肺泡灌洗液曲霉菌半乳甘露聚糖诊断。发生 CAPA 的患者均没有侵袭性真菌感染的典型危险因素。 CAPA 的发生率远低于其他中心报告的发生率，这可能反映了当地的流行病学情况。