tetano
Editor, Senior Moderator
Ann Clin Microbiol Antimicrob
. 2025 Jun 18;24(1):38.
doi: 10.1186/s12941-025-00805-8. SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis
Mengshu Xie[SUP] #[/SUP][SUP] 1 2 [/SUP], Xiaofeng Zhu[SUP] #[/SUP][SUP] 1 2 [/SUP], Ao Ma[SUP] #[/SUP][SUP] 1 2 [/SUP], Jiaqi Fan[SUP] 2 [/SUP], Guangru Fei[SUP] 2 [/SUP], Qianqian Zhou[SUP] 2 [/SUP], Yan Zhang[SUP] 3 [/SUP], Huimei Wu[SUP] 4 [/SUP], Xuqin Jiang[SUP] 5 6 [/SUP]
Affiliations
Background: COVID-19 associated pulmonary aspergillosis (CAPA) has been globally reported to be a life-threatening complication of severe COVID-19. Previous studies primarily focused on an association between secondary Aspergillus infection and elevated mortality risk in COVID-19 patients, while potential confounding factors and alternative pathogenic mechanisms remain insufficiently investigated. The risk factors and outcomes of patients with secondary SARS-CoV-2 infection following invasive pulmonary aspergillosis (IPA) were not been well explored either.
Methods: This retrospective monocentric study enrolled 152 hospitalized IPA patients with and without SARS-CoV-2 infection from 1 November 2022 to 31 October 2023. The characteristics of IPA patients and related risk factors were investigated, and the relationship between different SARS-CoV-2 infection status and the prognosis in IPA patients was further evaluated.
Results: Our analysis demonstrated that IPA patients subsequently diagnosed with SARS-CoV-2 infection exhibited significantly elevated mortality risk compared to those without viral coinfection (53.6% vs. 22.9%, P < 0.001). SARS-CoV-2 infection status (OR 3.708; P = 0.001; 95%CI 1.674-8.212), albumin concentration (OR 0.885; P = 0.005; 95%CI 0.813-0.964), and C-reactive protein level (OR 1.007; P = 0.012; 95%CI 1.002-1.013) were statistically significant independent risk factors for prognosis of IPA patients. Subsequent analysis established a multivariate risk prediction model incorporating independent prognostic factors, which exhibited robust discriminative capacity for mortality risk stratification via ROC curve validation (AUC = 0.792, 95%CI 0.721-0.862, P < 0.0001). A statistically significant difference in mortality rate existed between IPA patients with secondary SARS-CoV-2 infection and CAPA patients (63.2% and 33.3%, P = 0.037). Notably, comparative analysis revealed no statistically significant differences in 28-day (22/96, 22.9% vs. 6/18, 33.3%) or 90-day mortality rates (22/96, 22.9% vs. 6/18, 33.3%) between patients with IPA without SARS-CoV-2 infection and IPA patients with secondary SARS-CoV-2 infection.
Conclusions: IPA patients with secondary SARS-CoV-2 coinfection had a lower mortality compared to those with CAPA. Considering the high mortality rate, more medical cares are needed for these patients.
Keywords: COVID-19; COVID-19 associated pulmonary aspergillosis (CAPA); Invasive pulmonary aspergillosis (IPA); Risk factor; Secondary SARS-CoV-2 infection.
. 2025 Jun 18;24(1):38.
doi: 10.1186/s12941-025-00805-8. SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis
Mengshu Xie[SUP] #[/SUP][SUP] 1 2 [/SUP], Xiaofeng Zhu[SUP] #[/SUP][SUP] 1 2 [/SUP], Ao Ma[SUP] #[/SUP][SUP] 1 2 [/SUP], Jiaqi Fan[SUP] 2 [/SUP], Guangru Fei[SUP] 2 [/SUP], Qianqian Zhou[SUP] 2 [/SUP], Yan Zhang[SUP] 3 [/SUP], Huimei Wu[SUP] 4 [/SUP], Xuqin Jiang[SUP] 5 6 [/SUP]
Affiliations
- PMID: 40533753
- DOI: 10.1186/s12941-025-00805-8
Background: COVID-19 associated pulmonary aspergillosis (CAPA) has been globally reported to be a life-threatening complication of severe COVID-19. Previous studies primarily focused on an association between secondary Aspergillus infection and elevated mortality risk in COVID-19 patients, while potential confounding factors and alternative pathogenic mechanisms remain insufficiently investigated. The risk factors and outcomes of patients with secondary SARS-CoV-2 infection following invasive pulmonary aspergillosis (IPA) were not been well explored either.
Methods: This retrospective monocentric study enrolled 152 hospitalized IPA patients with and without SARS-CoV-2 infection from 1 November 2022 to 31 October 2023. The characteristics of IPA patients and related risk factors were investigated, and the relationship between different SARS-CoV-2 infection status and the prognosis in IPA patients was further evaluated.
Results: Our analysis demonstrated that IPA patients subsequently diagnosed with SARS-CoV-2 infection exhibited significantly elevated mortality risk compared to those without viral coinfection (53.6% vs. 22.9%, P < 0.001). SARS-CoV-2 infection status (OR 3.708; P = 0.001; 95%CI 1.674-8.212), albumin concentration (OR 0.885; P = 0.005; 95%CI 0.813-0.964), and C-reactive protein level (OR 1.007; P = 0.012; 95%CI 1.002-1.013) were statistically significant independent risk factors for prognosis of IPA patients. Subsequent analysis established a multivariate risk prediction model incorporating independent prognostic factors, which exhibited robust discriminative capacity for mortality risk stratification via ROC curve validation (AUC = 0.792, 95%CI 0.721-0.862, P < 0.0001). A statistically significant difference in mortality rate existed between IPA patients with secondary SARS-CoV-2 infection and CAPA patients (63.2% and 33.3%, P = 0.037). Notably, comparative analysis revealed no statistically significant differences in 28-day (22/96, 22.9% vs. 6/18, 33.3%) or 90-day mortality rates (22/96, 22.9% vs. 6/18, 33.3%) between patients with IPA without SARS-CoV-2 infection and IPA patients with secondary SARS-CoV-2 infection.
Conclusions: IPA patients with secondary SARS-CoV-2 coinfection had a lower mortality compared to those with CAPA. Considering the high mortality rate, more medical cares are needed for these patients.
Keywords: COVID-19; COVID-19 associated pulmonary aspergillosis (CAPA); Invasive pulmonary aspergillosis (IPA); Risk factor; Secondary SARS-CoV-2 infection.