{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:18:50Z","timestamp":1788261530911,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Fungi","JoF"],"abstract":"<jats:p>The role of severe COVID-19 as an independent risk factor for invasive aspergillosis remains debated, with reported incidences varying widely across studies. We compared the cumulative incidence, risk factors, and outcomes of invasive pulmonary mold infection (IPMI) in intensive care unit patients with confirmed COVID-19 during the first epidemic wave and subsequent waves up to March 2021 at La Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Paris, France. Patients were systematically screened for fungal infections and classified according to ECMM\/ISHAM criteria and a more stringent local assessment. The study included 259 patients (n = 171, first wave and n = 88, subsequent waves). Patient characteristics were similar between periods, although short-course corticosteroid therapy increased over time. Mortality rates remained unchanged. Cumulative incidence of IPMI did not differ significantly between waves, regardless of the classification system used: 12.1% versus 15.1% with ECMM\/ISHAM criteria and 4.2% versus 5.8% with local assessment. IPMI was associated with solid organ transplantation and pre-existing long-term corticosteroid therapy, whereas short-course corticosteroid therapy for COVID-19 was not associated with increased risk. IPMI was strongly associated with 90-day mortality. Classification as probable COVID-19-Associated Pulmonary Aspergillosis using the ECMM\/ISHAM criteria may be partly influenced by the number of diagnostic samples collected. Overall, our findings underline that the classification system substantially influences both incidence estimates and the interpretation of survival outcomes.<\/jats:p>","DOI":"10.3390\/jof12090652","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:32:18Z","timestamp":1788258738000},"page":"652","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive Aspergillosis Complicating Severe COVID-19: Cumulative Incidence, Risk Factors, and Outcomes Between the First Wave of the Pandemic and Subsequent Waves, According to the ECMM\/ISHAM Classification and a Local Case Assessment"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4432-7665","authenticated-orcid":false,"given":"Marion","family":"Blaize","sequence":"first","affiliation":[{"name":"Parasitologie-Mycologie, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"},{"name":"Centre d\u2019Immunologie et des Maladies Infectieuses (Cimi-Paris), Sorbonne Universit\u00e9, Inserm, CNRS, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-3553","authenticated-orcid":false,"given":"Charles","family":"Gibert","sequence":"additional","affiliation":[{"name":"Parasitologie-Mycologie, H\u00f4pital Saint-Antoine, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5542-1966","authenticated-orcid":false,"given":"Dimitri","family":"Kornblum","sequence":"additional","affiliation":[{"name":"Parasitologie-Mycologie, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Demeret","sequence":"additional","affiliation":[{"name":"R\u00e9animation Neurologique, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7634-5898","authenticated-orcid":false,"given":"Jean-Michel","family":"Constantin","sequence":"additional","affiliation":[{"name":"Groupe de Recherche Clinique en Anesth\u00e9sie R\u00e9animation M\u00e9decine P\u00e9riop\u00e9ratoire (GRC29), D\u00e9partement d\u2019Anesth\u00e9sie-R\u00e9animation, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Monsel","sequence":"additional","affiliation":[{"name":"R\u00e9animation Polyvalente, D\u00e9partement d\u2019Anesth\u00e9sie-R\u00e9animation, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"},{"name":"Immunologie-Immunopathologie-Immunoth\u00e9rapie (I3), UMR-S 959, Sorbonne Universit\u00e9, Inserm, 75013 Paris, France"},{"name":"Centre d\u2019Investigation Clinique Int\u00e9gr\u00e9 en Bioth\u00e9rapie et Immunologie (CIC-BTi), D\u00e9partement Inflammation-Immunopathologie-Bioth\u00e9rapie (DHU I2B), Sorbonne Universit\u00e9, Inserm, CNRS, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Mayaux","sequence":"additional","affiliation":[{"name":"R\u00e9animation M\u00e9dicale Polyvalente, D\u00e9partement Respiration R\u00e9animation R\u00e9habilitation Sommeil (R3S), Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles-Edouard","family":"Luyt","sequence":"additional","affiliation":[{"name":"M\u00e9decine Intensive R\u00e9animation, Institut de Cardiologie, Groupe Hospitalier La Piti\u00e9\u2013Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"},{"name":"Institute of Cardiometabolism and Nutrition (UMRS_1166-ICAN), Sorbonne Universit\u00e9, Inserm, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Lampros","sequence":"additional","affiliation":[{"name":"Parasitologie-Mycologie, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Kamus","sequence":"additional","affiliation":[{"name":"Parasitologie-Mycologie, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"},{"name":"D\u00e9partement de Biologie M\u00e9dicale, Centre Hospitalier Universitaire F\u00e9lix-Guyon, 97400 Saint-Denis, La R\u00e9union, France"},{"name":"Processus Infectieux en Milieu Insulaire Tropical (PIMIT) UMR 9192 CNRS-1187 Inserm-49 IRD, Universit\u00e9 de La R\u00e9union, 97400 Saint-Denis, La R\u00e9union, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-075X","authenticated-orcid":false,"given":"Arnaud","family":"Fekkar","sequence":"additional","affiliation":[{"name":"Parasitologie-Mycologie, Groupe Hospitalier La Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 75013 Paris, France"},{"name":"Centre d\u2019Immunologie et des Maladies Infectieuses (Cimi-Paris), Sorbonne Universit\u00e9, Inserm, CNRS, 75013 Paris, 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