{"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":1790834751296,"version":"4.1.0"},"reference-count":67,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>COVID\u201019\u2010associated pulmonary aspergillosis (CAPA) remains a high mortality mycotic infection throughout the pandemic, and glucocorticoids (GC) may be its root cause. Our aim was to evaluate the effect of systemic GC treatment on the development of CAPA. We systematically searched the PubMed, Google Scholar, Scopus and Embase databases to collect eligible studies published until 31 December 2022. The pooled outcome of CAPA development was calculated as the log odds ratio (LOR) with 95% confidence intervals (CI) using a random effect model. A total of 21 studies with 5174 patients were included. Of these, 20 studies with 4675 patients consisting of 2565 treated with GC but without other immunomodulators (GC group) and 2110 treated without GC or other immunomodulators (controls) were analysed. The pooled LOR of CAPA development was higher for the GC group than for the controls (0.54; 95% CI: 0.22, 0.86; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). In the subgroups, the pooled LOR was higher for high\u2010dose GC (0.90; 95% CI: 0.17, 1.62: <jats:italic>p<\/jats:italic>\u2009=\u2009.01) and dexamethasone (0.71; 95% CI: 0.35, 1.07; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) but had no significant difference for low\u2010dose GC (0.41; 95% CI: \u22120.07, 0.89; <jats:italic>p<\/jats:italic>\u2009=\u2009.09), and non\u2010dexamethasone GC (0.21; 95% CI: \u22120.36, 0.79; <jats:italic>p<\/jats:italic>\u2009=\u2009.47), treated patients versus controls. GC treatment increases the risk of CAPA development, and this risk is particularly associated with the use of high\u2010dose GC or dexamethasone treatment.<\/jats:p>","DOI":"10.1111\/myc.13637","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T05:25:52Z","timestamp":1691472352000},"page":"941-952","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Effect of glucocorticoids on the development of <scp>COVID<\/scp>\u201019\u2010associated pulmonary aspergillosis: A meta\u2010analysis of 21 studies and 5174 patients"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-4554","authenticated-orcid":false,"given":"Zia","family":"Hashim","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok","family":"Nath","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajmal","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anup","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Informatics Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riksoam","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radha Krishan","family":"Dhiman","sequence":"additional","affiliation":[{"name":"Department of Hepatology Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-2824","authenticated-orcid":false,"given":"Martin","family":"Hoenigl","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2621-802X","authenticated-orcid":false,"given":"Naresh Kumar","family":"Tripathy","sequence":"additional","affiliation":[{"name":"Department of Hematology Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO Coronavirus (COVID\u201019) Dashboard (2022). 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