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Incidence, risk factors found for pulmonary aspergillosis, an invasive fungal infection of lungs, among COVID-19 patients

COVID-19-associated pulmonary aspergillosis

The invasive fungal infection pulmonary aspergillosis is caused by the aspergillus fungus and has been known to occur among patients with COVID-19.

Credit: Yukihiro Kaneko, Osaka Metropolitan University

As society learns to live with COVID-19, research on the disease and its complications remains important. Thus, an Osaka Metropolitan University team has pored through data to understand the incidence in Japan of COVID-19-associated pulmonary aspergillosis (CAPA), a severe invasive fungal infection of the lungs.

Few studies have been conducted on CAPA in Japan, but reports from overseas put the incidence between 3.8% and 35%.

Using Japanese administrative claims data, Graduate School of Medicine Lecturer Waki Imoto, graduate student Mr. Yasutaka Ihara, Professor Ayumi Shintani, and Professor Hiroshi Kakeya were among the team analyzing CAPA, especially in patients with severe or critical COVID-19. The team studied over 150,000 COVID-19 cases from the full calendar years of 2020 and 2021, and approximately 33,000 patients were in the severe or critical category. 

Among these 33,000, CAPA occurred in 0.4% to 2.7% of patients, with men, older adults, the existence of respiratory diseases, and the use of dialysis treatments or blood transfusions as being at higher risk of getting the infection. Statistical analysis also showed the mortality rate was twice as high for patients with CAPA.

“The CAPA incidence rates obtained in this study were lower than those reported overseas. This result may be related to the fact that few facilities in Japan treated COVID-19 patients with CAPA in mind,” stated Dr. Imoto. “Since early detection of CAPA and treatment with antifungal drugs is important, we hope these results will lead to improved screening of COVID-19 patients.”

The findings were published in Mycoses.

Funding

This work was supported by the Research Program on Emerging and Reemerging Infectious Diseases from the Japan Agency for Medical Research and Development, AMED [grant numbers JP21fk0108094, JP22fk0108133]; MHLW Research Program on Emerging and Reemerging Infectious Diseases [grant number JPMH21HA2011, JPMH23HA2011]; and departmental funding from the Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Paper information

Journal: Mycoses
Title: Incidence and risk factors for coronavirus disease 2019-associated pulmonary aspergillosis using administrative claims data
DOI: 10.1111/myc.13773
Authors: Waki Imoto, Yasutaka Ihara, Takumi Imai, Ryota Kawai, Koichi Yamada, Yukihiro Kaneko, Ayumi Shintani, Hiroshi Kakeya
Published: 1 August 2024
URL: https://doi.org/10.1111/myc.13773

Contact

Waki Imoto

Graduate School of Medicine
Email: wakiimoto[at]omu.ac.jp

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