Clinical characteristics and risk factors for COVID-19-associated pulmonary aspergillosis
10.11816/cn.ni.2025-250379
- VernacularTitle:新型冠状病毒感染相关肺曲霉菌病临床特征及其危险因素
- Author:
Hua LAN
1
;
Pihua GONG
;
Haiying ZHANG
;
Kairui ZHANG
;
Xiaohui XIE
Author Information
1. 北京大学药学院药事管理与临床药学系,北京 100191
- Publication Type:Journal Article
- Keywords:
Acute respiratory distress syndrome;
COVID-19-associated pulmonary aspergillosis;
Clinical character-istic;
Risk factor
- From:
Chinese Journal of Nosocomiology
2025;35(19):2906-2910
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the clinical characteristics of patients with COVID-19-associated pulmonary as-pergillosis(CAPA)among those with acute respiratory distress syndrome(ARDS)and to analyze the risk factors for CAPA.METHODS A total of 117 patients with ARDS admitted to Peking University People's Hospital from Dec.1,2022 to Jan.31,2023 were selected.Based on the diagnostic criteria for CAPA,patients were divided into the CAPA group(n=13)and the non-CAPA group(n=104).Clinical characteristics of CAPA patients were ana-lyzed,and risk factors were summarized by multivariate logistic regression analysis.RESULTS Compared with non-CAPA patients,a high proportion of CAPA paitents had a low oxygenation index at admission(<200 mmHg:61.54%vs.39.42%),those required more invasive respiratory support(ventilator and EC MO:38.46%vs.5.77%),and had a glucocorticoid treatment duration>10 days(76.92%vs.16.35%).CAPA pa-tients also received more treatments such as tocilizumab(38.46%vs.11.54%)and antiviral drugs(92.31%vs.50.00%),had longer hospital stays(24.00 vs.16.00 days)and a higher in-hospital mortality rate(69.23%vs.21.15%).The use of invasive mechanical ventilation/ECMO during hospitalization(OR=11.386,P=0.013)and therapeutic doses of glucocorticoids for>10 days(OR=15.671,P<0.001)were risk factors for CAPA in patients with ARDS.CONCLUSIONS Among COVID-19 patients with ARDS,CAPA patients receive more thera-peutic drugs and treatments during hospitalization.CAPA is associated with the use of invasive mechanical ventila-tion or ECMO and prolonged use of therapeutic doses of glucocorticoids during hospitalization.