{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:05:20Z","timestamp":1790057120081,"version":"4.0.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The detection of\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      in the lower respiratory tract complicates the clinical course of viral pneumonia and is linked to poor outcomes, but prior evidence is confined to the intensive care unit (ICU) or single-virus settings (e.g., influenza or SARS-CoV-2). Whether its frequency and prognostic significance differ across viral etiologies in hospitalized adults remains unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter retrospective cohort study included adults with community-acquired viral pneumonia at seven tertiary hospitals in China (2017-2025). Patients were categorized into SARS-CoV-2, influenza, or other viral groups. The exposure was lower respiratory tract\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      detection (via using culture, real-time PCR, or metagenomic next-generation sequencing). The primary outcome was in-hospital all-cause mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 929 patients,\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      was detected in 175 (18.8%). The detection rates differed significantly across viral etiologies (33.2% in patients with influenza, 14.6% in those with SARS-CoV-2, and 7.4% in those with other viruses; P &amp;lt; 0.001). In the fully adjusted model,\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      detection was independently associated with increased overall mortality (aOR = 2.99; 95% CI 1.60\u20135.58; P &amp;lt; 0.001), but the association varied markedly by viral etiology. Virus-stratified analyses revealed that in influenza,\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      detection remained independently associated with mortality after multivariable adjustment, and the association was consistently observed across prespecified subgroups, including non-ventilated patients, whereas in SARS-CoV-2, the association was largely confined to ventilated patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Lower respiratory tract\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      detection differed substantially by viral etiology and was most frequent in patients with influenza pneumonia. It was independently associated with increased mortality across all influenza subgroups, including non-ventilated patients, whereas in SARS-CoV-2 pneumonia this association was largely confined to mechanical ventilation patients. These findings support a virus-stratified approach to fungal surveillance and warrant prospective validation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1906021","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:39:48Z","timestamp":1790055588000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Detection of Aspergillus in the lower respiratory tract and its association with mortality in patients with different viral pneumonias: a retrospective multicenter cohort study from China"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaohua","family":"Li","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Fuzhou First General Hospital Affiliated with Fujian Medical University","place":["Fuzhou, China"]},{"name":"Department of Pulmonary and Critical Care Medicine, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Xicheng District Zhanlanlu Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xufeng","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Seventh Affiliated Hospital of Sun Yat-sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deqing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Diseases, Air Force Medical Center, Chinese People\u2019s Liberation","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinqian","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shukun","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Shijiazhuang People\u2019s Hospital","place":["Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1056\/NEJMoa2015432","article-title":"Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in covid-19","volume":"383","author":"Ackermann","year":"2020","journal-title":"N. 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