{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T19:22:43Z","timestamp":1784056963692,"version":"3.55.0"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI176770"],"award-info":[{"award-number":["R01AI176770"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aspergillosis is a fungal infection associated with rising hospitalizations and substantial morbidity and mortality. In the United States, data remain fragmented due to the absence of centralized surveillance. This study aimed to evaluate demographic, geographic, and temporal trends in aspergillosis diagnoses across the United States and evaluate changes in those patterns following the emergence of COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using electronic health record data from 142\u2005US healthcare systems (Oracle Health), including adults aged \u226518 years who received care between 2013 and 2023. The cohort included over 76 million patients and 127 million person-years. Aspergillosis prevalence was calculated using post-stratification weights. Adjusted prevalence ratios (aPRs) were estimated via quasi-Poisson and Bayesian spatiotemporal regression. COVID-19-related shifts were evaluated using estimated marginal means.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2013 to 2023, aspergillosis prevalence increased by 5% annually, peaking in 2022. Rhode Island had the highest state-level aPR; Utah the lowest. Diagnosis was higher among males (aPR 1.37), older adults (\u226565 years vs 18\u201324 years: aPR 4.95), and urban residents (rural aPR 0.86). Following the emergence of COVID-19, prevalence increased disproportionately among Hispanic or Latino patients and several racial minority groups. A nonsignificant upward trend was also observed among rural residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides a comprehensive national assessment of aspergillosis diagnosis patterns in the United States, revealing rising prevalence and shifts in affected populations following the emergence of COVID-19. These findings may aid earlier clinical recognition, especially among groups not traditionally considered high-risk, and support efforts to expand diagnostic access and improve fungal disease surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag094","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T12:49:15Z","timestamp":1772023755000},"source":"Crossref","is-referenced-by-count":1,"title":["Epidemiology of Aspergillosis Diagnoses in US Adults Using a National EHR Database, 2013\u20132023"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0280-0904","authenticated-orcid":false,"given":"Brittany L","family":"Morgan Bustamante","sequence":"first","affiliation":[{"name":"Division of Environmental Health Sciences, University of California , Berkeley, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elijah 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