COVID-19-associated pulmonary aspergillosis in a tertiary care center in the Midwestern Region of Brazil

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as a complication following COVID-19 infections. This study aimed to evaluate the clinical and epidemiological data of CAPA cases in a tertiary hospital. Conducted retrospectively from February 2020 to January 2024, it involved the analysis of medical records to identify CAPA cases based on the diagnostic criteria established by the European Confederation of Medical Mycology and the International Society for Human and Animal Mycology. Seven patients were identified as possible CAPA cases, of whom 71.43% had pre-existing comorbidities. All patients received corticosteroid therapy, and 42.86% required prolonged mechanical ventilation. The study revealed a high mortality rate, with 71.43% of patients succumbing to the condition. The diagnosis of CAPA is challenging due to the invasiveness of definitive tests, such as biopsies, and the lack of resources for essential diagnostics like galactomannan detection. Despite the limited sample size, the findings align with existing literature, indicating a high prevalence of comorbidities, prior corticosteroid use, and mechanical ventilation as significant risk factors. This study underscores the critical need for heightened awareness, early diagnosis, and proactive management strategies for CAPA in severely ill COVID-19 patients to reduce risks and improve patient outcomes.