TY - JOUR AU - Marr, Kieren AU - Platt, Andrew AU - Tornheim, Jeffrey AU - Zhang, Sean AU - Datta, Kausik AU - Cardozo, Celia AU - Garcia-Vidal, Carolina T1 - Aspergillosis Complicating Severe Coronavirus Disease T2 - Emerging Infectious Disease journal PY - 2021 VL - 27 IS - 1 SP - 18 SN - 1080-6059 AB - Aspergillosis complicating severe influenza infection has been increasingly detected worldwide. Recently, coronavirus disease–associated pulmonary aspergillosis (CAPA) has been detected through rapid reports, primarily from centers in Europe. We provide a case series of CAPA, adding 20 cases to the literature, with review of pathophysiology, diagnosis, and outcomes. The syndromes of pulmonary aspergillosis complicating severe viral infections are distinct from classic invasive aspergillosis, which is recognized most frequently in persons with neutropenia and in other immunocompromised persons. Combined with severe viral infection, aspergillosis comprises a constellation of airway-invasive and angio-invasive disease and results in risks associated with poor airway fungus clearance and killing, including virus- or inflammation-associated epithelial damage, systemic immunosuppression, and underlying lung disease. Radiologic abnormalities can vary, reflecting different pathologies. Prospective studies reporting poor outcomes in CAPA patients underscore the urgent need for strategies to improve diagnosis, prevention, and therapy. KW - aspergillosis KW - Aspergillus KW - fungi KW - complications KW - severe viral pneumonia KW - coronavirus disease KW - COVID-19 KW - severe acute respiratory syndrome coronavirus 2 KW - SARS-CoV-2 KW - respiratory infections KW - fungal infections KW - zoonoses DO - 10.3201/eid2701.202896 UR - https://wwwnc.cdc.gov/eid/article/27/1/20-2896_article ER - End of Reference