The following is a summary of “COVID-19 associated pulmonary aspergillosis in critically ill patients: a prospective multicenter study in the era of Delta and Omicron variants,” published in the April 2024 issue of Critical Care by Bay et al.

Emerging SARS-CoV-2 variants and changing patient profiles raise questions about COVID-19-associated pulmonary aspergillosis (CAPA) in patients with critical illness.

Researchers conducted a prospective study to determine the characteristics of CAPA in patients with critical illness during the era of new variants.

They conducted a cohort study in France involving 36 participating ICUs (December 7th, 2021, to April 26th, 2023). The diagnosis criteria for CAPA relied on the European Confederation of Medical Mycology (ECMM) consensus criteria and the International Society for Human & Animal Mycology (ISHAM).

The results showed that in 566 patients, the prevalence of CAPA was 5.1% [95% CI 3.4–7.3], increasing to 9.1% among patients requiring invasive mechanical ventilation (IMV). In univariable analysis, patients with CAPA were more frequently immunosuppressed and required IMV, vasopressors, and renal replacement therapy during ICU stay compared to patients with non-CAPA. In multivariable logistic regression analysis, SAPS II score at ICU admission, immunosuppression, and SARS-CoV-2 Delta variant were independently associated with CAPA. Although not significantly linked with day-28 mortality, patients with CAPA had prolonged mechanical ventilation and ICU stay durations.

Investigators found CAPA in patients who were critically ill with COVID-19 decreased during the Delta/Omicron era (5.1%), impacting ventilated patients and extending ICU stays.

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01296-0