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We investigated the clinical features and prognosis of patients with <jats:italic>Aspergillus<\/jats:italic> isolation from LRT specimens during acute exacerbation of chronic obstructive pulmonary disease (AECOPD).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a 6-year single-center, real-world study. 75 cases out of 1131 hospitalized AECOPD patients were positive for <jats:italic>Aspergillus<\/jats:italic>. These patients were carefully evaluated and finally diagnosed of pulmonary aspergillosis (PA, 60 cases, 80%) or colonization (15 cases, 20%). Comparisons of clinical data were performed between these two groups. A cox regression model was used to confirm prognostic factors of <jats:italic>Aspergillus<\/jats:italic> infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The PA group had worse lung function and higher rates of systemic corticosteroid use and broad-spectrum antibiotic use before admission than the colonization group. The PA group had significantly higher in-hospital mortality and 180-day mortality than the colonization group (45% (27\/60) vs. 0% (0\/15), <jats:italic>p<\/jats:italic>\u2009=\u20090.001, and 52.5% (31\/59) vs. 6.7% (1\/15), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001<jats:italic>,<\/jats:italic> respectively). By multivariable analysis among <jats:italic>Aspergillus<\/jats:italic> infection patients, antifungal therapy (HR 0.383, 95% CI 0.163\u20130.899, <jats:italic>p<\/jats:italic>\u2009=\u20090.027) was associated with improved survival, whereas accumulated dose of systemic steroids\u2009&gt;\u2009700\u00a0mg (HR 2.452, 95% CI 1.134\u20135.300, <jats:italic>p<\/jats:italic>\u2009=\u20090.023) and respiratory failure at admission (HR 5.983, 95% CI 2.487\u201314.397, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were independently associated with increased mortality<jats:bold>.<\/jats:bold> Significant survival differential was observed among PA patients without antifungals and antifungals initiated before and after <jats:italic>Aspergillus<\/jats:italic> positive culture (<jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p><jats:italic>Aspergillus<\/jats:italic> isolation in hospitalized AECOPD patients largely indicated PA. AECOPD patients with PA had worse prognosis than those with <jats:italic>Aspergillus<\/jats:italic> colonization. Empirical antifungal therapy is warranted to improve the prognosis for <jats:italic>Aspergillus<\/jats:italic> infection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-021-01427-4","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T10:08:40Z","timestamp":1614334120000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Clinical features and prognostic analysis of patients with Aspergillus isolation during acute exacerbation of chronic obstructive pulmonary disease"],"prefix":"10.1186","volume":"21","author":[{"given":"Yu","family":"Gu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianping","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunlu","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjin","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"issue":"4","key":"1427_CR1","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1111\/resp.13032","volume":"22","author":"JM Leung","year":"2017","unstructured":"Leung JM, Tiew PY, Mac Aogain M, Budden KF, Yong VF, Thomas SS, Pethe K, Hansbro PM, Chotirmall SH. 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The informed consent was obtained from all participants in written form. All methods were performed in accordance with relevant guidelines and regulations.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing interest to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"69"}}