SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis
Abstract Background COVID-19 associated pulmonary aspergillosis (CAPA) has been globally reported to be a life-threatening complication of severe COVID-19. Previous studies primarily focused on an association between secondary Aspergillus infection and elevated mortality risk in COVID-19 patients, w...
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BMC
2025-06-01
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| Series: | Annals of Clinical Microbiology and Antimicrobials |
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| Online Access: | https://doi.org/10.1186/s12941-025-00805-8 |
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| author | Mengshu Xie Xiaofeng Zhu Ao Ma Jiaqi Fan Guangru Fei Qianqian Zhou Yan Zhang Huimei Wu Xuqin Jiang |
| author_facet | Mengshu Xie Xiaofeng Zhu Ao Ma Jiaqi Fan Guangru Fei Qianqian Zhou Yan Zhang Huimei Wu Xuqin Jiang |
| author_sort | Mengshu Xie |
| collection | DOAJ |
| description | Abstract Background COVID-19 associated pulmonary aspergillosis (CAPA) has been globally reported to be a life-threatening complication of severe COVID-19. Previous studies primarily focused on an association between secondary Aspergillus infection and elevated mortality risk in COVID-19 patients, while potential confounding factors and alternative pathogenic mechanisms remain insufficiently investigated. The risk factors and outcomes of patients with secondary SARS-CoV-2 infection following invasive pulmonary aspergillosis (IPA) were not been well explored either. Methods This retrospective monocentric study enrolled 152 hospitalized IPA patients with and without SARS-CoV-2 infection from 1 November 2022 to 31 October 2023. The characteristics of IPA patients and related risk factors were investigated, and the relationship between different SARS-CoV-2 infection status and the prognosis in IPA patients was further evaluated. Results Our analysis demonstrated that IPA patients subsequently diagnosed with SARS-CoV-2 infection exhibited significantly elevated mortality risk compared to those without viral coinfection (53.6% vs. 22.9%, P < 0.001). SARS-CoV-2 infection status (OR 3.708; P = 0.001; 95%CI 1.674–8.212), albumin concentration (OR 0.885; P = 0.005; 95%CI 0.813–0.964), and C-reactive protein level (OR 1.007; P = 0.012; 95%CI 1.002–1.013) were statistically significant independent risk factors for prognosis of IPA patients. Subsequent analysis established a multivariate risk prediction model incorporating independent prognostic factors, which exhibited robust discriminative capacity for mortality risk stratification via ROC curve validation (AUC = 0.792, 95%CI 0.721–0.862, P < 0.0001). A statistically significant difference in mortality rate existed between IPA patients with secondary SARS-CoV-2 infection and CAPA patients (63.2% and 33.3%, P = 0.037). Notably, comparative analysis revealed no statistically significant differences in 28-day (22/96, 22.9% vs. 6/18, 33.3%) or 90-day mortality rates (22/96, 22.9% vs. 6/18, 33.3%) between patients with IPA without SARS-CoV-2 infection and IPA patients with secondary SARS-CoV-2 infection. Conclusions IPA patients with secondary SARS-CoV-2 coinfection had a lower mortality compared to those with CAPA. Considering the high mortality rate, more medical cares are needed for these patients. |
| format | Article |
| id | doaj-art-c3c56a2438eb445f9db9e1fdf7e97633 |
| institution | OA Journals |
| issn | 1476-0711 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj-art-c3c56a2438eb445f9db9e1fdf7e976332025-08-20T02:10:34ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112025-06-0124111110.1186/s12941-025-00805-8SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosisMengshu Xie0Xiaofeng Zhu1Ao Ma2Jiaqi Fan3Guangru Fei4Qianqian Zhou5Yan Zhang6Huimei Wu7Xuqin Jiang8Department of Pulmonary Medicine, School of Clinical Medicine, Bengbu Medical UniversityDepartment of Pulmonary Medicine, School of Clinical Medicine, Bengbu Medical UniversityDepartment of Pulmonary Medicine, School of Clinical Medicine, Bengbu Medical UniversityDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaSchool of Health Service Management, Anhui Medical UniversityAnhui Geriatric Institute, Department of Geriatric Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Pulmonary Medicine, School of Clinical Medicine, Bengbu Medical UniversityAbstract Background COVID-19 associated pulmonary aspergillosis (CAPA) has been globally reported to be a life-threatening complication of severe COVID-19. Previous studies primarily focused on an association between secondary Aspergillus infection and elevated mortality risk in COVID-19 patients, while potential confounding factors and alternative pathogenic mechanisms remain insufficiently investigated. The risk factors and outcomes of patients with secondary SARS-CoV-2 infection following invasive pulmonary aspergillosis (IPA) were not been well explored either. Methods This retrospective monocentric study enrolled 152 hospitalized IPA patients with and without SARS-CoV-2 infection from 1 November 2022 to 31 October 2023. The characteristics of IPA patients and related risk factors were investigated, and the relationship between different SARS-CoV-2 infection status and the prognosis in IPA patients was further evaluated. Results Our analysis demonstrated that IPA patients subsequently diagnosed with SARS-CoV-2 infection exhibited significantly elevated mortality risk compared to those without viral coinfection (53.6% vs. 22.9%, P < 0.001). SARS-CoV-2 infection status (OR 3.708; P = 0.001; 95%CI 1.674–8.212), albumin concentration (OR 0.885; P = 0.005; 95%CI 0.813–0.964), and C-reactive protein level (OR 1.007; P = 0.012; 95%CI 1.002–1.013) were statistically significant independent risk factors for prognosis of IPA patients. Subsequent analysis established a multivariate risk prediction model incorporating independent prognostic factors, which exhibited robust discriminative capacity for mortality risk stratification via ROC curve validation (AUC = 0.792, 95%CI 0.721–0.862, P < 0.0001). A statistically significant difference in mortality rate existed between IPA patients with secondary SARS-CoV-2 infection and CAPA patients (63.2% and 33.3%, P = 0.037). Notably, comparative analysis revealed no statistically significant differences in 28-day (22/96, 22.9% vs. 6/18, 33.3%) or 90-day mortality rates (22/96, 22.9% vs. 6/18, 33.3%) between patients with IPA without SARS-CoV-2 infection and IPA patients with secondary SARS-CoV-2 infection. Conclusions IPA patients with secondary SARS-CoV-2 coinfection had a lower mortality compared to those with CAPA. Considering the high mortality rate, more medical cares are needed for these patients.https://doi.org/10.1186/s12941-025-00805-8COVID-19COVID-19 associated pulmonary aspergillosis (CAPA)Invasive pulmonary aspergillosis (IPA)Secondary SARS-CoV-2 infectionRisk factor |
| spellingShingle | Mengshu Xie Xiaofeng Zhu Ao Ma Jiaqi Fan Guangru Fei Qianqian Zhou Yan Zhang Huimei Wu Xuqin Jiang SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis Annals of Clinical Microbiology and Antimicrobials COVID-19 COVID-19 associated pulmonary aspergillosis (CAPA) Invasive pulmonary aspergillosis (IPA) Secondary SARS-CoV-2 infection Risk factor |
| title | SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis |
| title_full | SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis |
| title_fullStr | SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis |
| title_full_unstemmed | SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis |
| title_short | SARS-CoV-2 coinfection in patients with invasive pulmonary aspergillosis: clinical characteristics and prognosis |
| title_sort | sars cov 2 coinfection in patients with invasive pulmonary aspergillosis clinical characteristics and prognosis |
| topic | COVID-19 COVID-19 associated pulmonary aspergillosis (CAPA) Invasive pulmonary aspergillosis (IPA) Secondary SARS-CoV-2 infection Risk factor |
| url | https://doi.org/10.1186/s12941-025-00805-8 |
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