{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:25:34Z","timestamp":1789133134382,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data on mixed mould infection with COVID\u201019\u2010associated pulmonary aspergillosis (CAPA) and COVID\u201019\u2010associated pulmonary mucormycosis (CAPM) are sparse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To ascertain the prevalence of co\u2010existent CAPA in CAPM (mixed mould infection) and whether mixed mould infection is associated with early mortality (\u22647\u2009days of diagnosis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed the data collected from 25 centres across India on COVID\u201019\u2010associated mucormycosis. We included only CAPM and excluded subjects with disseminated or rhino\u2010orbital mucormycosis. We defined co\u2010existent CAPA if a respiratory specimen showed septate hyphae on smear, histopathology or culture grew <jats:italic>Aspergillus<\/jats:italic> spp. We also compare the demography, predisposing factors, severity of COVID\u201019, and management of CAPM patients with and without CAPA. Using a case\u2013control design, we assess whether mixed mould infection (primary exposure) were associated with early mortality in CAPM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 105 patients with CAPM. The prevalence of mixed mould infection was 20% (21\/105). Patients with mixed mould infection experienced early mortality (9\/21 [42.9%] vs. 15\/84 [17.9%]; p\u2009=\u20090.02) and poorer survival at 6\u2009weeks (7\/21 [33.3] vs. 46\/77 [59.7%]; p\u2009=\u20090.03) than CAPM alone. On imaging, consolidation was more commonly encountered with mixed mould infections than CAPM. Co\u2010existent CAPA (odds ratio [95% confidence interval], 19.1 [2.62\u2013139.1]) was independently associated with early mortality in CAPM after adjusting for hypoxemia during COVID\u201019 and other factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Coinfection of CAPA and CAPM was not uncommon in our CAPM patients and portends a worse prognosis. Prospective studies from different countries are required to know the impact of mixed mould infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13745","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T11:54:38Z","timestamp":1716206078000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence of co\u2010existent <scp>COVID<\/scp>\u201019\u2010associated pulmonary aspergillosis (<scp>CAPA<\/scp>) and its impact on early mortality in patients with <scp>COVID<\/scp>\u201019\u2010associated pulmonary mucormycosis (<scp>CAPM<\/scp>)"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0410-8468","authenticated-orcid":false,"given":"Valliappan","family":"Muthu","sequence":"first","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-7668","authenticated-orcid":false,"given":"Ritesh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-9253","authenticated-orcid":false,"given":"Shivaprakash Mandya","family":"Rudramurthy","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Thangaraju","sequence":"additional","affiliation":[{"name":"Kovai Medical Center and Hospital  Coimbatore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj Radhakishan","family":"Shevkani","sequence":"additional","affiliation":[{"name":"Avron Hospitals  Ahmedabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6575-2460","authenticated-orcid":false,"given":"Atul K.","family":"Patel","sequence":"additional","affiliation":[{"name":"Sterling Hospital  Ahmedabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-8076","authenticated-orcid":false,"given":"Prakash Srinivas","family":"Shastri","sequence":"additional","affiliation":[{"name":"Sir Gangaram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwini","family":"Tayade","sequence":"additional","affiliation":[{"name":"Kingsway Hospital  Nagpur Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Sawai Man Singh Medical College  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishwanath","family":"Gella","sequence":"additional","affiliation":[{"name":"Asian Institute of Gastroenterology  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthi","family":"Savio","sequence":"additional","affiliation":[{"name":"St. John's Medical College and Hospital  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surabhi","family":"Madan","sequence":"additional","affiliation":[{"name":"Care Institute of Medical Sciences  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1001-7717","authenticated-orcid":false,"given":"Vinaykumar","family":"Hallur","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Science Bhubaneswar  Odisha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkata Nagarjuna","family":"Maturu","sequence":"additional","affiliation":[{"name":"Yashoda Hospitals  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Royal Care Hospital  Coimbatore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Sethuraman","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raminder Pal Singh","family":"Sibia","sequence":"additional","affiliation":[{"name":"Government Medical College  Patiala Punjab India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Pujari","sequence":"additional","affiliation":[{"name":"Poona Hospital and Research Centre  Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindra","family":"Mehta","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanu","family":"Singhal","sequence":"additional","affiliation":[{"name":"Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1111-1008","authenticated-orcid":false,"given":"Puneet","family":"Saxena","sequence":"additional","affiliation":[{"name":"Army Hospital (Research and Referral)  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Government Medical College  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasant","family":"Nagvekar","sequence":"additional","affiliation":[{"name":"Global Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parikshit","family":"Prayag","sequence":"additional","affiliation":[{"name":"Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmesh","family":"Patel","sequence":"additional","affiliation":[{"name":"City Clinic and Bhailal Amin General Hospital  Vadodara Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immaculata","family":"Xess","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Savaj","sequence":"additional","affiliation":[{"name":"Institute of Infectious Disease and Critical Care Hospital  Surat Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inderpaul Singh","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh","family":"Panda","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayathri Devi","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Kovai Medical Center and Hospital  Coimbatore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riya Sandeep","family":"Parwani","sequence":"additional","affiliation":[{"name":"Avron Hospitals  Ahmedabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Sterling Hospital  Ahmedabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Kingsway Hospital  Nagpur Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Vyas","sequence":"additional","affiliation":[{"name":"Sawai Man Singh Medical College  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghava Rao","family":"Gandra","sequence":"additional","affiliation":[{"name":"Asian Institute of Gastroenterology  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas Kishore","family":"Sistla","sequence":"additional","affiliation":[{"name":"Asian Institute of Gastroenterology  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyadarshini A.","family":"Padaki","sequence":"additional","affiliation":[{"name":"St. John's Medical College and Hospital  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharshni","family":"Ramar","sequence":"additional","affiliation":[{"name":"Care Institute of Medical Sciences  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj Kumar","family":"Panigrahi","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Science Bhubaneswar  Odisha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurav","family":"Sarkar","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Science Bhubaneswar  Odisha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharani","family":"Rachagulla","sequence":"additional","affiliation":[{"name":"Yashoda Hospitals  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pattabhiraman","family":"Vallandaramam","sequence":"additional","affiliation":[{"name":"Royal Care Hospital  Coimbatore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna Prabha","family":"Premachandran","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Pawar","sequence":"additional","affiliation":[{"name":"Government Medical College  Patiala Punjab India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyush","family":"Gugale","sequence":"additional","affiliation":[{"name":"Poona Hospital and Research Centre  Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Hosamani","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil Narayan","family":"Dutt","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Nair","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hariprasad","family":"Kalpakkam","sequence":"additional","affiliation":[{"name":"Apollo Hospitals  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv","family":"Badhwar","sequence":"additional","affiliation":[{"name":"Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8631-1317","authenticated-orcid":false,"given":"Kiran Kumar","family":"Kompella","sequence":"additional","affiliation":[{"name":"Army Hospital (Research and Referral)  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Singla","sequence":"additional","affiliation":[{"name":"Government Medical College  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind","family":"Navlakhe","sequence":"additional","affiliation":[{"name":"Global Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2498-9576","authenticated-orcid":false,"given":"Amrita","family":"Prayag","sequence":"additional","affiliation":[{"name":"Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gagandeep","family":"Singh","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poorvesh","family":"Dhakecha","sequence":"additional","affiliation":[{"name":"Institute of Infectious Disease and Critical Care Hospital  Surat Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunaloke","family":"Chakrabarti","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13604"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30312-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(21)00237-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.08.014"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2709.210934"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1073_23"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-023-00808-z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2023.12.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13274"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13328"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2021.101231"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4266\/acc.2021.01340"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2901.220926"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13591"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00124-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-009615"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13263"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1008"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-015-9904-3"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202306-1022ED"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000977"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2006.03.006"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.04.010"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/arm91050027"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.12.035"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-021-00584-8"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30847-1"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202208-1570OC"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2021.101228"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238825"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201111-1978OC"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13335"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13745","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T09:55:08Z","timestamp":1717062908000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/myc.13745"],"URL":"https:\/\/doi.org\/10.1111\/myc.13745","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2024-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13745"}}