Abstract
The aim of this study was to describe the patient's characteristics and clinical course of CAPA and to investigate possible association of Dexamethasone with CAPA incidence.This is a retrospective descriptive study. All adult patients in GGC NHS with laboratory proven SARS-CoV-2 infection who subsequently had Aspergillus species isolated from their respiratory samples between 01/02/20 and 31/01/21were included.A total of 24 patients fulfilled the inclusion criteria.79% of the cases were between October/2020-January/2021 coinciding with the second wave of COVID-19 and the increased use of steroids after the RECOVERY trial results. Based on the proposed screening and diagnostic algorithm for CAPA and Modified AspITU classification, 6 patients had likely/putative, and 2 patients had highly likely/probable CAPA, respectively.Based on the CAPA algorithm, for 11 patients CAPA was not excluded and 5 considered colonization. Based on Modified AspITU, 10 considered query Putative CAPA and 6 colonization. 13 patients were males. The median age was 62. 46% of patients had underlying lung disease, 20% had previous exposure to inhaled steroids, 8% to Methotrexate, 4% to each of systemic steroids and Rituximab. 79% of patients received Dexamethasone and 12.5% received Tocilizumab for COVID-19. 75% of patients were in ITU at time of first Aspergillus isolation. 67% of patients received antifungal for CAPA.CAPA remains an area of research. From our limited data, we observed an association between Dexamethasone use and incidence of CAPA. We also noticed a correlation between the number of samples with positive Aspergillus species culture from the same patient and the likelihood of CAPA diagnosis.
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