‘New entity’ of COVID-19-associated aspergillosis linked to poor outcomes

ByEamon N. Dreisbach

Patients with COVID-19-associated pulmonary aspergillosis, or CAPA, experience worse outcomes than COVID-19 patients who do not have the fungal infection, according to study results published in Clinical Infectious Diseases.

“Physicians should be mindful about this new entity, particularly in at-risk patient populations,” Nitipong Permpalung, MD, MPH, an assistant professor of medicine at Johns Hopkins University School of Medicine, told Healio. “CAPA is associated with poor outcomes, which include higher severity of illness, longer ventilatory and hemodynamic support, and longer duration of hospitalization. Early diagnosis and treatment may improve these outcomes.”

PVD patients — Source: Permpalung N, et al. *Clin Infect Dis*. 2021;doi:10.1093/cid/ciab223.

Permpalung and colleagues conducted a retrospective cohort study of 396 mechanically ventilated adults with COVID-19 who were admitted five Johns Hopkins hospitals. They analyzed clinical outcomes, longitudinal disease severity and incidence of CAPA.

A total of 39 of the 396 patients had CAPA. The researchers found that patients with CAPA had a higher likelihood of having underlying pulmonary vascular disease than those without (41% vs. 21.6%; P = .01), and a higher likelihood of liver disease (35.9% vs 18.2%; P =.02), coagulopathy (51.3% vs. 33.1%; P = .03), solid tumors (25.6% vs. 10.9%; P = .017), multiple myeloma (5.1% vs. 0.3%; P = .027) and corticosteroid exposure (66.7% vs. 42.6%; P = .005).

Nitipong Permpalung

Permpalung said the study’s limitations included its retrospective design, confounding variables that may affect clinical outcomes and use of data for patient comorbidities, and an inability to determine if the receipt of an antifungal agent would be associated with better clinical outcomes.

“Further multicenter, prospective studies are needed to optimize diagnostics and improve clinical strategies for screening, prevention and therapy,” Permpalung said.

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Sources/Disclosures

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Source:

Permpalung N, et al. Clin Infect Dis. 2021;doi:10.1093/cid/ciab223.

Disclosures: Permpalung reports receiving consulting and advisory board income from Shionogi and study grant support from the Cystic Fibrosis Foundation, the Fisher Center Discovery Program at Johns Hopkins School of Medicine, Health Systems Research Institute, the NIH and the Thailand Ministry of Public Health. Please see the study for all other authors’ relevant financial disclosures.