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Hospitalised COPD patients develop IA in 1.3\u20133.9%, based on positive cultures of\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      spp. and radiological findings. Given limited data on per-patient annual hospitalisation rates, we assumed a conservative 10.5% estimate. Annual IA mortality in COPD was estimated using the literature rates of 43\u201372%. A separate literature search assessed the impact of\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      sensitisation on severity of COPD (by FEV1).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We re-estimated the global prevalence of COPD GOLD stages II-IV at 552,300,599 people (7.39% of the population) with 339,206,893 (8.58%) in Asia, 85,278,783 (8.52%) in the Americas, 64,298,051 (5.37%) in Africa, 59,484,329 (7.77%) in Europe and 4,032,543 (10.86%) in Oceania. An estimated 57,991,563 (10.5%) people with COPD are admitted to hospital annually and of these 753,073 (1.3%) \u2013 2,272,322 (3.9%) develop IA and 540,451\u2013977,082 deaths are predicted annually.\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      sensitisation prevalence in COPD was 13.6% (7.0\u201318.3%) and not related to lower predicted FEV1% (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of COPD is much higher than previously estimated. Overall COPD mortality may be higher than estimated and IA probably contributes to many deaths. Improved rapid diagnosis of IA using culture and non-culture based techniques is required in COPD hospital admissions to reduce mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-020-01259-8","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T23:53:04Z","timestamp":1599781984000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["The global impact of Aspergillus infection on COPD"],"prefix":"10.1186","volume":"20","author":[{"given":"Emily E.","family":"Hammond","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles S.","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen","family":"Vestbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W.","family":"Denning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,11]]},"reference":[{"issue":"1","key":"1259_CR1","doi-asserted-by":"publisher","first-page":"15076","DOI":"10.1038\/nrdp.2015.76","volume":"1","author":"PJ Barnes","year":"2015","unstructured":"Barnes PJ, Burney PGJ, Silverman EK, et al. 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JV reports personal fees from GlaxoSmithKline, personal fees from Chiesi Pharmaceuticals, personal fees from Boehringer-Ingelheim, personal fees from Novartis, personal fees from AstraZeneca, grants from Boehringer-Ingelheim, outside the submitted work. DWD reports that he and family hold Founder shares in F2G Ltd., a University of Manchester spin-out antifungal discovery company. He acts or has recently acted as a consultant to Scynexis, Pulmatrix, Pulmocide, Zambon, iCo Therapeutics, Mayne Pharma, Roivant, Biosergen, and Fujifilm. In the last 3\u2009years, he has been paid for talks on behalf of Dynamiker, Hikma, Gilead, Merck, Mylan and Pfizer. He is a longstanding member of the Infectious Disease Society of America Aspergillosis Guidelines group, the European Society for Clinical Microbiology and Infectious Diseases Aspergillosis Guidelines group.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"241"}}