{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:01:50Z","timestamp":1773885710709,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early identification of COVID\u201019\u2010associated pulmonary aspergillosis (CAPA) is particularly challenging in low\u2010 middle\u2010income countries where diagnostic capabilities are limited, and risk factors for CAPA have not been identified. It is also essential to recognise CAPA patients who are likely to have a poorer outcome to decide on aggressive management approaches. Therefore, this study aimed to identify risk factors and outcomes for CAPA among admitted moderate to critical COVID\u201019 patients at our centre in Pakistan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An unmatched case\u2013control study with ratio of 1:2 was conducted on hospitalised adult patients with COVID\u201019 from March 2020\u2013July 2021. Cases were defined according to European Confederation of Medical Mycology and the International Society for Human and Animal Mycology consensus criteria. Controls were defined as patients hospitalised with moderate, severe or critical COVID\u201019 without CAPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 100 CAPA cases (27 probable CAPA; 73 possible CAPA) were compared with 237 controls. Critical disease at presentation (aOR 5.04; 95% CI 2.18\u201311.63), age\u00a0\u2265\u200960\u2009years (aOR 2.00; 95% CI 1.20\u20133.35) and underlying co\u2010morbid of chronic kidney disease (CKD) (aOR 3.78; 95% CI 1.57\u20139.08) were identified as risk factors for CAPA. Patients with CAPA had a significantly greater proportion of complications and longer length of hospital stay (<jats:italic>p<\/jats:italic>\u2010value\u2009&lt;\u2009.001). Mortality was higher in patients with CAPA (48%) as compared to those without CAPA (13.5%) [OR\u00a0=\u00a06.36(95% CI 3.6\u201311)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CAPA was significantly associated with advanced age, CKD and critical illness at presentation, along with a greater frequency of complications and higher mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13529","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T06:49:48Z","timestamp":1663310988000},"page":"69-74","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of risk factors and outcome of patients with and without <scp>COVID<\/scp>\u201019\u2010associated pulmonary aspergillosis from Pakistan: A case\u2013control study"],"prefix":"10.1111","volume":"66","author":[{"given":"Nosheen","family":"Nasir","sequence":"first","affiliation":[{"name":"Department of Medicine Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joveria","family":"Farooqi","sequence":"additional","affiliation":[{"name":"Department of Pathology &amp; Laboratory Medicine Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Muhammad","family":"Zubair","sequence":"additional","affiliation":[{"name":"Department of Medicine Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maaha","family":"Ayub","sequence":"additional","affiliation":[{"name":"Medical College Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahmeer","family":"Khan","sequence":"additional","affiliation":[{"name":"Medical College Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Hassaan","family":"Wiqar","sequence":"additional","affiliation":[{"name":"Research Facilitation Office Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Faisal","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Medicine Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2497-7847","authenticated-orcid":false,"given":"Kauser","family":"Jabeen","sequence":"additional","affiliation":[{"name":"Department of Pathology &amp; Laboratory Medicine Aga Khan University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.08.014"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2704.204895"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.10.022"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13135"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13255"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271333"},{"key":"e_1_2_10_8_1","unstructured":"Organization WH.Living guidance for clinical management of COVID\u201019: 2021.2022.https:\/\/apps.who.int\/iris\/rest\/bitstreams\/1394399\/retrieve"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30847-1"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06510-2"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1544"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-021-01701-x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13434"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2022.37.e134"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13466"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2022.069"},{"issue":"5","key":"e_1_2_10_17_1","first-page":"790.e791","article-title":"Risk factors associated with COVID\u201019\u2010associated pulmonary aspergillosis in ICU patients: a French multicentric retrospective cohort","volume":"27","author":"Delli\u00e8re S","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2021.04.012"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11050632"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13433"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13328"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-020-00731-8"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6020041"},{"key":"e_1_2_10_24_1","first-page":"1421","article-title":"Airborne fungal flora of Karachi, Pakistan","volume":"41","author":"Rao T","year":"2009","journal-title":"Pak J Bot"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01229-21"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2022.01.027"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-017-2919-6"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13529","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.13529","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T14:46:25Z","timestamp":1692629185000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,22]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/myc.13529"],"URL":"https:\/\/doi.org\/10.1111\/myc.13529","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,22]]},"assertion":[{"value":"2022-07-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}