{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:40:54Z","timestamp":1784112054873,"version":"3.55.0"},"reference-count":99,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Direcci\u00f3n General de Asuntos del Personal Acad\u00e9mico (PAPIIT-DGAPA)","award":["IT201318"],"award-info":[{"award-number":["IT201318"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>COVID-19-associated pulmonary aspergillosis (CAPA) has had a high incidence. In addition, it has been associated with prolonged hospital stays, as well as several predisposing risk factors, such as fungal factors (nosocomial organism, the size of the conidia, and the ability of the Aspergillus spp. of colonizing the respiratory tract), environmental factors (remodeling in hospitals, use of air conditioning and negative pressure in intensive care units), comorbidities, and immunosuppressive therapies. In addition to these factors, SARS-CoV-2 per se is associated with significant dysfunction of the patient\u2019s immune system, involving both innate and acquired immunity, with reduced CD4+ and CD8+ T cell counts and cytokine storm. Therefore, this review aims to identify the factors influencing the fungus so that coinfection with SARS-CoV-2 can occur. In addition, we analyze the predisposing factors in the fungus, host, and the immune response alteration due to the pathogenicity of SARS-CoV-2 that causes the development of CAPA.<\/jats:p>","DOI":"10.3390\/pathogens11111227","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T05:11:33Z","timestamp":1666761093000},"page":"1227","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Aspergillus-SARS-CoV-2 Coinfection: What Is Known?"],"prefix":"10.3390","volume":"11","author":[{"given":"Carlos Alberto","family":"Castro-Fuentes","sequence":"first","affiliation":[{"name":"Departamento de Microbiolog\u00eda y Parasitolog\u00eda, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Avenida Universidad 3000, Ciudad Universitaria, Coyoac\u00e1n, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3866-9995","authenticated-orcid":false,"given":"Mar\u00eda del Roc\u00edo","family":"Reyes-Montes","sequence":"additional","affiliation":[{"name":"Departamento de Microbiolog\u00eda y Parasitolog\u00eda, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Avenida Universidad 3000, Ciudad Universitaria, Coyoac\u00e1n, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Guadalupe","family":"Fr\u00edas-De-Le\u00f3n","sequence":"additional","affiliation":[{"name":"Hospital Regional de Alta Especialidad de Ixtapaluca, Carretera Federal M\u00e9xico-Puebla Km. 34.5, Pueblo de Zoquiapan, Ixtapaluca 56530, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-7946","authenticated-orcid":false,"given":"Omar E.","family":"Valencia-Ledezma","sequence":"additional","affiliation":[{"name":"Hospital Regional de Alta Especialidad de Ixtapaluca, Carretera Federal M\u00e9xico-Puebla Km. 34.5, Pueblo de Zoquiapan, Ixtapaluca 56530, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Acosta-Altamirano","sequence":"additional","affiliation":[{"name":"Hospital Regional de Alta Especialidad de Ixtapaluca, Carretera Federal M\u00e9xico-Puebla Km. 34.5, Pueblo de Zoquiapan, Ixtapaluca 56530, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6315-7860","authenticated-orcid":false,"given":"Esperanza","family":"Duarte-Escalante","sequence":"additional","affiliation":[{"name":"Departamento de Microbiolog\u00eda y Parasitolog\u00eda, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Avenida Universidad 3000, Ciudad Universitaria, Coyoac\u00e1n, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"ref_1","first-page":"242","article-title":"SARS-CoV-2: Biology, detection, macrophage mediated pathogenesis and potential treatments","volume":"4","author":"Cartagena","year":"2020","journal-title":"Virol. Immunol. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/jmv.25722","article-title":"Understanding of COVID-19 based on current evidence","volume":"92","author":"Sun","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100678","DOI":"10.1016\/j.nmni.2020.100678","article-title":"All about COVID-19 in brief","volume":"35","author":"Naserghandi","year":"2020","journal-title":"New Microbes New Infect."},{"key":"ref_4","unstructured":"Worldometers (2022, July 04). Info. Dover, Delaware, USA. Available online: https:\/\/www.worldometers.info\/coronavirus\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/bs.aivir.2019.08.002","article-title":"Structural insights into coronavirus entry","volume":"105","author":"Tortorici","year":"2019","journal-title":"Adv. Virus Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2790","DOI":"10.1002\/jmv.26598","article-title":"Mutations in membrane-fusion subunit of spike glycoprotein play crucial role in the recent outbreak of COVID-19","volume":"93","author":"Podder","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"628370","DOI":"10.3389\/fmed.2021.628370","article-title":"A Review of SARS-CoV2: Compared with SARS-CoV and MERS-CoV","volume":"8","author":"Zhou","year":"2021","journal-title":"Front. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"569760","DOI":"10.3389\/fimmu.2020.569760","article-title":"SARS-CoV-2: Immune response elicited by infection and development of vaccines and treatments","volume":"11","author":"Saavedra","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.cell.2020.02.058","article-title":"Structure, function, and dntigenicity of the SARS-CoV-2 spike glycoprotein","volume":"180","author":"Walls","year":"2020","journal-title":"Cell"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"711616","DOI":"10.3389\/fpubh.2021.711616","article-title":"COVID-19: Pulmonary and extra pulmonary manifestations","volume":"9","author":"Elrobaa","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jinf.2020.05.046","article-title":"Co-infections in people with COVID-19: A systematic review and meta-analysis","volume":"81","author":"Lansbury","year":"2020","journal-title":"J. Infect."},{"key":"ref_12","first-page":"e7","article-title":"COVID-19 mechanisms in the human body\u2014What we know so far","volume":"3","author":"Kumar","year":"2021","journal-title":"Front Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Arastehfar, A., Carvalho, A., van de Veerdonk, F.L., Jenks, J.D., Koehler, P., Krause, R., Cornely, O.A., SPerlin, D., Lass-Fl\u00f6r, C., and Hoenig, M. (2020). COVID-19 associated pulmonary aspergillosis (CAPA)-From Immunology to Treatment. J. Fungi Basel Switz., 6.","DOI":"10.3390\/jof6020091"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJMoa2021436","article-title":"Dexamethasone in hospitalized patients with COVID-19. N","volume":"384","author":"Horby","year":"2021","journal-title":"Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S271","DOI":"10.1080\/13693780802227159","article-title":"Invasive aspergillosis in glucocorticoid-treated patients","volume":"47","author":"Lewis","year":"2009","journal-title":"Med. Mycol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jmii.2020.09.004","article-title":"Covid-19 associated with pulmonary aspergillosis: A literature review","volume":"54","author":"Lai","year":"2021","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1016\/S2213-2600(20)30237-X","article-title":"Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID19","volume":"8","author":"Alanio","year":"2020","journal-title":"Lancet Respir Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1111\/myc.13096","article-title":"COVID-19 associated pulmonary aspergillosis","volume":"63","author":"Koehler","year":"2020","journal-title":"Mycoses"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.3201\/eid2704.204895","article-title":"COVID-19\u2013Associated Pulmonary Aspergillosis, March\u2013August 2020","volume":"27","author":"Sprute","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101039","DOI":"10.1016\/j.mycmed.2020.101039","article-title":"Fatal aspergillosis complicating severe SARS-CoV-2 infection: A case report","volume":"30","author":"Schein","year":"2020","journal-title":"J. Mycol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1164\/rccm.202004-1038LE","article-title":"COVID-19-associated pulmonary aspergillosis","volume":"202","author":"Rijpstra","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"101752","DOI":"10.1016\/j.tmaid.2020.101752","article-title":"Invasive pulmonary aspergillosis complicating SARS-CoV-2 pneumonia: A diagnostic challenge","volume":"38","author":"Antinori","year":"2020","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e3606","DOI":"10.1093\/cid\/ciaa1065","article-title":"Epidemiology of invasive pulmonary Aspergillosis among intubated patients with COVID-19: A prospective study","volume":"73","author":"Bartoletti","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.3201\/eid2607.201603","article-title":"Fatal invasive aspergillosis and coronavirus disease in an immunocompetent patient","volume":"26","author":"Blaize","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_25","first-page":"e02136","article-title":"COVID-19-Associated invasive aspergillosis: Data from the UK National Mycology Reference Laboratory","volume":"59","author":"Borman","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e0244","DOI":"10.1097\/CCE.0000000000000244","article-title":"Risk factors for invasive pulmonary aspergillosis in critically ill patients with coronavirus disease 2019-induced acute respiratory distress syndrome","volume":"2","author":"Chauvet","year":"2020","journal-title":"Crit. Care Explor."},{"key":"ref_27","first-page":"790.e1","article-title":"Risk factors associated with COVID-19-associated pulmonary aspergillosis in ICU patients: A French multicentric retrospective cohort","volume":"27","author":"Dudoignon","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/mmy\/myaa078","article-title":"Pulmonary aspergillosis in critically ill patients with coronavirus disease 2019 (COVID-19)","volume":"59","author":"Dupont","year":"2020","journal-title":"Med. Mycol."},{"key":"ref_29","first-page":"15","article-title":"Recovery of a triazole-resistant Aspergillus fumigatus in respiratory specimen of COVID-19 patient in ICU-A case report","volume":"31","author":"Saade","year":"2020","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Gangneux, J.P., Reizine, F., Guegan, H., Pinceaux, K., Le Balch, P., Prat, E., Pelletier, R., Belaz, S., Le Souhaitier, M., and Le Tulzo, Y. (2020). Is the COVID-19 pandemic a good time to include Aspergillus molecular detection to categorize aspergillosis in ICU patients? A monocentric experience. J. Fungi, 6.","DOI":"10.3390\/jof6030105"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.cmi.2020.07.047","article-title":"Invasive aspergillosis in patients with severe COVID-19 pneumonia","volume":"27","author":"Helleberg","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lahmer, T., Kriescher, S., Herner, A., Rothe, K., Spinner, C.D., Schneider, J., Mayer, U., Neuenhahn, M., Hoffmann, D., and Geisler, F. (2021). Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: Results from the prospective AspCOVID-19 study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0238825"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1016\/j.cmi.2020.07.010","article-title":"Incidence of invasive pulmonary aspergillosis among critically ill COVID-19 patients","volume":"26","author":"Lamoth","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/S1473-3099(20)30200-0","article-title":"Clinical and virological data of the first cases of COVID-19 in Europe: A case series","volume":"20","author":"Lescure","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/myc.13213","article-title":"Invasive pulmonary aspergillosis in the COVID-19 era: An expected new entity","volume":"64","author":"Machado","year":"2020","journal-title":"Mycoses"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/myc.13254","article-title":"COVID-19\u2013associated pulmonary aspergillosis: A prospective single-center dual case series","volume":"64","author":"Meijer","year":"2021","journal-title":"Mycoses"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.mmcr.2020.06.005","article-title":"Multi-triazole-resistant Aspergillus fumigatus and SARS-CoV-2 co-infection: A lethal combination","volume":"31","author":"Mohamed","year":"2021","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1111\/myc.13135","article-title":"COVID-19-associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID-19 pneumonia: An observational study from Pakistan","volume":"63","author":"Nasir","year":"2020","journal-title":"Mycoses"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.mmcr.2020.05.001","article-title":"Invasive pulmonary aspergillosis complicating COVID-19 in the ICU\u2014A case report","volume":"31","author":"Prattes","year":"2020","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_40","first-page":"364","article-title":"Accuracy of galactomannan testing on tracheal aspirates in COVID-19-associated pulmonary aspergillosis","volume":"64","year":"2020","journal-title":"Mycoses"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s13613-020-00686-4","article-title":"COVID-19-associated invasive pulmonary aspergillosis","volume":"10","author":"Rutsaert","year":"2020","journal-title":"Ann. Intensive Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e20200401","DOI":"10.1590\/0037-8682-0401-2020","article-title":"Confirmed invasive pulmonary aspergillosis and COVID-19: The value of postmortem findings to support antemortem management","volume":"53","author":"Santana","year":"2020","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/myc.13219","article-title":"Prevalence of opportunistic invasive aspergillosis in COVID-19 patients with severe pneumonia","volume":"64","author":"Carrillo","year":"2021","journal-title":"Mycoses"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.mmcr.2020.06.002","article-title":"COVID-19 associated pulmonary aspergillosis (CAPA): An Australian case report","volume":"31","author":"Sharma","year":"2020","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1164\/rccm.202005-2018LE","article-title":"Detection of invasive pulmonary aspergillosis in COVID-19 with nondirected BAL","volume":"202","author":"Kwa","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1093\/mmy\/myab009","article-title":"COVID-19-associated invasive pulmonary aspergillosis in a tertiary care center in Mexico City","volume":"59","author":"Cuenca","year":"2021","journal-title":"Med. Mycol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"101122","DOI":"10.1016\/j.mycmed.2021.101122","article-title":"Invasive pulmonary aspergillosis in COVID-19 critically ill patients: Results of a French monocentric cohort","volume":"31","author":"Versyck","year":"2021","journal-title":"J. Mycol. Med."},{"key":"ref_48","first-page":"1631","article-title":"Navigating the uncertainties of COVID-19 associated aspergillosis (CAPA): A comparison with influenza associated aspergillosis (IAPA)","volume":"224","author":"Lamoth","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1111\/myc.13341","article-title":"A review of significance of Aspergillus detection in airways of ICU COVID-19 patients","volume":"64","author":"Pasquier","year":"2021","journal-title":"Mycoses"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/j.cmi.2021.06.025","article-title":"COVID-19-associated pulmonary aspergillosis (CAPA): How big a problem is it?","volume":"27","author":"Fekkar","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1016\/S2666-5247(21)00091-4","article-title":"Invasive mould disease in fatal COVID-19: A systematic review of autopsies","volume":"2","author":"Kula","year":"2021","journal-title":"Lancet Microbe"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciw326","article-title":"Practice guidelines for the diagnosis and management of Aspergillosis: 2016 update by the infectious diseases society of America","volume":"63","author":"Patterson","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1056\/NEJMra2027424","article-title":"Aspergillus infections","volume":"385","author":"Thompson","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_54","first-page":"151","article-title":"Airborne Aspergillus fumigatus conidia: A risk factor for aspergillosis","volume":"25","year":"2021","journal-title":"Fungal Biol. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1128\/CMR.12.2.310","article-title":"Aspergillus fumigatus and aspergillosis","volume":"12","year":"1999","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1146\/annurev.micro.56.012302.160625","article-title":"Menacing mold: The molecular biology of Aspergillus fumigatus","volume":"56","author":"Brakhage","year":"2002","journal-title":"Annu. Rev. Microbiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1128\/CMR.00055-08","article-title":"Pathogenesis of Aspergillus fumigatus in invasive aspergillosis","volume":"22","author":"Dagenais","year":"2009","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1111\/j.1462-5822.2010.01517.x","article-title":"Aspergillus fumigatus: Contours of an opportunistic human pathogen","volume":"12","author":"McCormick","year":"2010","journal-title":"Cell. Microbiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S2213-2600(21)00138-7","article-title":"COVID-19-associated Aspergillus tracheobronchitis: The interplay between viral tropism, host defence, and fungal invasion","volume":"9","author":"Vos","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_60","first-page":"313","article-title":"Colonization by multidrug-resistant microorganisms in ICU patients during the COVID-19 pandemic","volume":"45","author":"Morenoa","year":"2021","journal-title":"Med. Intensiva"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1186\/s13054-020-03221-w","article-title":"Impact of negative air pressure in ICU rooms on the risk of pulmonary aspergillosis in COVID-19 patients","volume":"24","author":"Ichai","year":"2020","journal-title":"Crit. Care"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"ofab510","DOI":"10.1093\/ofid\/ofab510","article-title":"Coronavirus disease 2019-associated invasive fungal infection","volume":"8","author":"Baddley","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"myac031","DOI":"10.1093\/mmy\/myac031","article-title":"Millon investigation of the value of precipitins in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with a positive marker for Aspergillus species","volume":"60","author":"Bellanger","year":"2022","journal-title":"Med. Mycol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Gregoire, E., Pirotte, B.F., Moerman, F., Altdorfer, A., Gaspard, L., Firre, E., Moonen, M., Fraipont, V., Ernst, M., and Darcis, G. (2021). Incidence and risk factors of COVID-19-associated pulmonary aspergillosis in intensive care unit-A monocentric retrospective observational study. Pathogens, 10.","DOI":"10.3390\/pathogens10111370"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"753659","DOI":"10.3389\/fmed.2021.753659","article-title":"Risk factors for invasive aspergillosis in patients admitted to the intensive care unit with coronavirus disease 2019: A multicenter retrospective study","volume":"8","author":"Xu","year":"2021","journal-title":"Front. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.cmi.2021.08.014","article-title":"Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology","volume":"28","author":"Prattes","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jointm.2021.07.001","article-title":"COVID-19-Associated pulmonary aspergillosis (CAPA)","volume":"1","author":"Dimopoulos","year":"2021","journal-title":"J. Intensive Med."},{"key":"ref_68","first-page":"75","article-title":"Immunological response to COVID-19 and its role as a predisposing factor in invasive aspergillosis","volume":"6","author":"Tavakoli","year":"2020","journal-title":"Curr. Med. Mycol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41479-021-00083-w","article-title":"The role of co-infections and secondary infections in patients with COVID-19","volume":"13","author":"Feldman","year":"2021","journal-title":"Pneumonia"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e149","DOI":"10.1016\/S1473-3099(20)30847-1","article-title":"Defining and managing COVID-19-associated pulmonary aspergillosis: The 2020 ECMM\/ISHAM consensus criteria for research and clinical guidance","volume":"21","author":"Koehler","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Feys, S., Almyroudi, M.P., Braspenning, R., Lagrou, K., Spriet, I., Dimopoulos, G., and Wauters, J.A. (2021). Visual and comprehensive review on COVID-19-Associated Pulmonary Aspergillosis (CAPA). J. Fungi, 7.","DOI":"10.3390\/jof7121067"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2892","DOI":"10.3201\/eid2711.211174","article-title":"Multinational observational cohort study of COVID-19-associated pulmonary aspergillosis","volume":"27","author":"Janssen","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3826","DOI":"10.1111\/ene.15008","article-title":"COVID-19 and ischemic stroke","volume":"28","author":"Sagris","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.redar.2022.01.002","article-title":"Muerte cerebral debida a aspergilosis cerebral en un paciente de COVID-19","volume":"69","author":"Videla","year":"2022","journal-title":"Rev. Esp. Anestesiol. Y Reanim."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1016\/j.jiph.2021.10.010","article-title":"Opportunistic mycoses in COVID-19 patients\/survivors: Epidemic inside a pandemic","volume":"14","author":"Bhotla","year":"2021","journal-title":"J. Infect. Public Health"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s00134-021-06449-4","article-title":"Taskforce report on the diagnosis and clinical management of COVID-19 associated pulmonary aspergillosis","volume":"47","author":"Verweij","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e00094-21","DOI":"10.1128\/CMR.00094-21","article-title":"Pathogenesis of respiratory viral and fungal coinfections","volume":"35","author":"Salazar","year":"2022","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.3389\/fimmu.2019.02247","article-title":"Immunosenescence and its hallmarks: How to oppose aging strategically? A review of potential options for therapeutic intervention","volume":"10","author":"Aiello","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e2144","DOI":"10.1002\/rmv.2144","article-title":"Why the elderly appear to be more severely affected by COVID-19: The potential role of immunosenescence and CMV","volume":"30","author":"Kadambari","year":"2020","journal-title":"Rev. Med. Virol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12979-021-00234-z","article-title":"A potential association between immunosenescence and high COVID-19 related mortality among elderly patients with cardiovascular diseases","volume":"18","author":"Wang","year":"2021","journal-title":"Immun. Ageing"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/S2213-8587(20)30271-0","article-title":"Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: A population-based cohort study","volume":"8","author":"Holman","year":"2020","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41574-020-00435-4","article-title":"COVID-19 and diabetes mellitus: From pathophysiology to clinical management","volume":"17","author":"Lim","year":"2021","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1007\/s11010-022-04356-w","article-title":"Mechanisms contributing to adverse outcomes of COVID-19 in obesity","volume":"477","author":"Sudhakar","year":"2022","journal-title":"Mol. Cell Biochem."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"6049","DOI":"10.18632\/aging.103000","article-title":"Does comorbidity increase the risk of patients with COVID-19: Evidence from meta-analysis","volume":"12","author":"Wang","year":"2020","journal-title":"Aging"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s15010-021-01701-x","article-title":"Comparing the clinical characteristics and outcomes of COVID-19-associate pulmonary aspergillosis (CAPA): A systematic review and meta-analysis","volume":"50","author":"Chong","year":"2022","journal-title":"Infection"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Apostolopoulou, A., Garrigos, Z.E., Vijayvargiya, P., Lerner, A.H., and Farmakiotis, D. (2020). Invasive pulmonary aspergillosis in patients with SARS-CoV-2 infection: A systematic review of the literature. Diagnostics, 10.","DOI":"10.3390\/diagnostics10100807"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1086\/315027","article-title":"Protease from Aspergillus fumigatus induce interleukin (IL)-6 and IL-8 producin in airway epithelial cell lines by transcriptional mechanisms","volume":"180","author":"Borger","year":"1999","journal-title":"J. Infect. Dis."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"eabd7114","DOI":"10.1126\/sciimmunol.abd7114","article-title":"Comprehensive mapping of immune perturbations associated with severe COVID-19","volume":"5","author":"Pampena","year":"2020","journal-title":"Sci. Immunol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"312","DOI":"10.17843\/rpmesp.2020.372.5490","article-title":"COVID-19: Respuesta inmune y perspectivas terap\u00e9uticas","volume":"37","year":"2020","journal-title":"Rev. Peru Med. Exp. Salud P\u00fablica"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/j.mayocp.2020.03.024","article-title":"Urgent guidance for navigating and circumventing the QTc-prolonging and torsadogenic potential of possible pharmaco-therapies for Coronavirus Disease 19 (COVID-19)","volume":"95","author":"Giudicessi","year":"2020","journal-title":"Mayo Clin. Proc."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1002\/psp4.12573","article-title":"Investigational treatments for COVID-19 may increase ventricular arrhythmia risk through drug interactions","volume":"10","author":"Varshneya","year":"2021","journal-title":"CPT Pharmacomet. Syst. Pharmacol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"S168","DOI":"10.1093\/mmy\/myy052","article-title":"Broad spectrum triazoles for invasive mould infections in adults: Which drug and when?","volume":"57","author":"Jenks","year":"2019","journal-title":"Med. Mycol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1128\/AAC.01902-12","article-title":"In vitro antifungal susceptibility of clinically relevant species belonging to Aspergillus section Flavi","volume":"57","author":"Stchigel","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"e00399-19","DOI":"10.1128\/AAC.00399-19","article-title":"Echinocandins for the treatment of invasive aspergillosis: From laboratory to bedside","volume":"63","author":"Aruanno","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"e01229-21","DOI":"10.1128\/JCM.01229-21","article-title":"Aspergillus test profiles and mortality in critically Ill COVID-19 patients","volume":"59","author":"Alanio","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"110876","DOI":"10.1016\/j.mehy.2022.110876","article-title":"Multifaceted efficacy of caspofungin against fungal infections in COVID-19 patients","volume":"164","author":"Itoh","year":"2022","journal-title":"Med. Hypotheses"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Mohamed, A., Rogers, T.R., and Talento, A.F. (2020). COVID-19 Associated invasive pulmonary aspergillosis: Diagnostic and therapeutic challenges. J. Fungi., 6.","DOI":"10.3390\/jof6030115"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1186\/s13054-021-03753-9","article-title":"Antifungal prophylaxis 815 for prevention of COVID-19-associated pulmonary aspergillosis in critically ill patients: An observational study","volume":"25","author":"Hatzl","year":"2021","journal-title":"Crit. Care"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/11\/1227\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:02:09Z","timestamp":1760144529000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/11\/1227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,25]]},"references-count":99,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["pathogens11111227"],"URL":"https:\/\/doi.org\/10.3390\/pathogens11111227","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,25]]}}}