Clinical features and outcome of patients with chronic pulmonary aspergillosis in China: A retrospective, observational study

Abstract

Chronic pulmonary aspergillosis (CPA) is a confusing respiratory disease, with many fundamental questions unanswered. We retrospectively evaluated the clinical characteristics, treatment, and outcome of patients with CPA in a tertiary hospital in China. Forty-six patients with CPA, including 26 patients with chronic cavitary pulmonary aspergillosis (CCPA), 13 patients with subacute invasive pulmonary aspergillosis (SAIA) and 7 patients with simple pulmonary aspergilloma (SA), were diagnosed from January 2014 to December 2017. A total of 18 patients with CCPA and 8 patients with SAIA had completed triazole treatment. Patients with SAIA had lower body mass index than patients with CCPA (18.9 vs. 20.4, P=0.011), and SAIA most frequently occurred in systematic diseases (62.5% vs. 11.1%, P=0.014). The medians of white blood count and C-reactive protein in patients with SAIA were higher than those in patients with CCPA (P<0.001). No significant difference was observed in the median of duration of treatment between patients with CCPA and SAIA (36.5weeks vs. 27.5weeks, P=0.144). Based on a composite of clinical, radiological, and mycological criteria, global success was observed in 12 patients with CCPA (66.7%) and 6 patients with SAIA (75.0%) at the end of the treatment. During the 1-year follow-up, 9 of 26 patients with CPA (34.6%) had a relapse. To date, we face a tremendous lack of evidence on CPA, and no commonly accepted treatment endpoint definition has been defined. In the future, collaborative research activities are needed to meet these challenges.