{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:53:35Z","timestamp":1774529615911,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>COVID\u201019\u2013associated pulmonary aspergillosis (CAPA) has emerged as an invasive fungal disease, often affecting previously immunocompetent, mechanically ventilated, intensive care unit (ICU) patients. Incidence rates of 3.8%\u201333.3% have been reported depending on the geographic area, with high (47%) mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Here, we describe a single\u2010centre prospective case series with CAPA cases from both the first (March\u2010May, <jats:italic>n<\/jats:italic>\u00a0=\u00a05\/33) and second (mid\u2010September through mid\u2010December, <jats:italic>n<\/jats:italic>\u00a0=\u00a08\/33) COVID\u201019 wave at a 500\u2010bed teaching hospital in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>In the first COVID\u201019 wave, a total of 265 SARS\u2010CoV\u20102 PCR\u2010positive patients were admitted to our hospital of whom 33 needed intubation and mechanical ventilation. In the second wave, 508 SARS\u2010CoV\u20102 PCR\u2010positive patients were admitted of whom 33 needed mechanical ventilation. Data were prospectively collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found a significant decrease in COVID\u201019 patients needing mechanical ventilation in the ICU in the second wave (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01). From these patients, however, a higher percentage were diagnosed with CAPA (24.2% vs 15.2%), although not significant (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.36). All CAPA patients encountered in the second wave received dexamethasone. Mortality between both groups was similarly high (40%\u201350%). Moreover, we found environmental TR<jats:sub>34<\/jats:sub>\/L98H azole\u2010resistant <jats:italic>Aspergillus fumigatus<\/jats:italic> isolates in two separate patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this series, 19.7% (<jats:italic>n<\/jats:italic>\u00a0=\u00a013\/66) of mechanically ventilated SARS\u2010CoV\u20102 patients were diagnosed with CAPA. In addition, we found a significant reduction in COVID\u201019 patients needing mechanical ventilation on the ICU in the second wave. Numbers are too small to determine whether there is a true difference in CAPA incidence in mechanically ventilated patients between the two waves, and whether it could be attributed to dexamethasone SARS\u2010CoV\u20102 therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13254","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T07:34:46Z","timestamp":1613028886000},"page":"457-464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["COVID\u201019\u2013associated pulmonary aspergillosis: a prospective single\u2010center dual case series"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-024X","authenticated-orcid":false,"given":"Eelco F. J.","family":"Meijer","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology Radboud University Medical Center Nijmegen The Netherlands"},{"name":"Center of Expertise in Mycology Radboudumc\/CWZ Nijmegen The Netherlands"},{"name":"Department of Medical Microbiology and Infectious Diseases Canisius Wilhelmina Hospital (CWZ) Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton S. M.","family":"Dofferhoff","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases Canisius Wilhelmina Hospital (CWZ) Nijmegen The Netherlands"},{"name":"Department of Internal Medicine Canisius Wilhelmina Hospital (CWZ) Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar","family":"Hoiting","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Canisius Wilhelmina Hospital (CWZ) Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboud University Medical Center Nijmegen The Netherlands"},{"name":"Center of Expertise in Mycology Radboudumc\/CWZ Nijmegen The Netherlands"},{"name":"Department of Medical Microbiology and Infectious Diseases Canisius Wilhelmina Hospital (CWZ) Nijmegen The Netherlands"},{"name":"Bioprocess Engineering and Biotechnology Graduate Program Federal University of Paran\u00e1 Curitiba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"e_1_2_7_2_1","article-title":"A national strategy to diagnose COVID\u201019 associated invasive fungal disease in the ICU","author":"White PL","year":"2020","journal-title":"Clin Infect 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