{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:05:51Z","timestamp":1790834751304,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T00:00:00Z","timestamp":1737849600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study was conducted to further understand the clinical characteristics of COVID\u201019 associated pulmonary aspergillosis (CAPA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, we conducted a multicenter retrospective survey, which included patients with COVID\u201019 from five hospitals in Zhejiang, China. A total of 197 patients with COVID\u201019 were included in the study. The detailed clinical data of seven patients with CAPA from COVID\u201019 onset to 28\u2009days after CAPA were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the total of 197 patients, 36 were admitted to the intensive care unit (ICU), 13 received mechanical ventilation; among them, nine received extracorporeal membrane oxygenation (ECMO). All seven cases acquired CAPA in the ICU, six cases during MV, of which five cases received ECMO treatment at the same time, and one case had been off ventilation. The average duration from onset of COVID\u201019 to CAPA was 25.4\u2009days, from ICU admission to CAPA was 23.4\u2009days, and from MV to CAPA was 22.1\u2009days. All seven patients were diagnosed with CAPA without neutropenia, four with lymphopenia, seven with decreased CD4+ T lymphocyte, and five with decreased CD8+ T lymphocyte. All cases received glucocorticoids before CAPA, with an average duration of 15\u2009days and an average cumulative dose of 762.5\u2009mg prednisolone. In addition, all patients suffered bacterial infections and received antibacterial agents before CAPA, with an average duration of 22.6\u2009days. CAPA was diagnosed according to a positive culture of <jats:styled-content style=\"fixed-case\"><jats:italic>Aspergillus fumigatus<\/jats:italic><\/jats:styled-content> in sputum or bronchoalveolar lavage fluid (BALF) and positive serum 1,3\u2010\u03b2\u2010<jats:sc>d<\/jats:sc>\u2010glucan in all seven patients; serum galactomannan was positive in three cases. Rhizopus was cultured from BALF of one case during treatment of CAPA. All patients received antifungal therapy, and the 28\u2010day survival rate was 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of CAPA in patients with COVID\u201019 admitted to the ICU was 19.44%, all patients with CAPA had a history of chronic underlying diseases, and all had a history of high dose glucocorticoid. Patients with CAPA had no specific clinical symptoms and lung imaging manifestations, and diagnosis depended on Aspergillus culture and galactomannan detection. For patients with COVID\u201019 with these high\u2010risk factors, <jats:italic>Aspergillus<\/jats:italic> culture and GM testing should be performed actively to avoid delaying the diagnosis of CAPA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.70048","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T03:48:11Z","timestamp":1737949691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Features of COVID\u201019 Associated Pulmonary Aspergillosis: A Multicenter, Retrospective Study"],"prefix":"10.1111","volume":"19","author":[{"given":"Yasheng","family":"Zhan","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou Zhejiang China"},{"name":"Department of Critical Care Medicine Jinhua People's Hospital  Jinhua Zhejiang 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