Investigators in Spain and the United States have added 20 new case reports to mounting evidence that patients with coronavirus disease 2019 (COVID-19) are vulnerable to developing pulmonary aspergillosis. Authors of the case series noted that increased physician awareness in recent years of an association between severe influenza and the fungal infection may have led to more rapid recognition of coronavirus disease–associated pulmonary aspergillosis (CAPA).
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The new cases of CAPA were identified at Johns Hopkins Medical Center in Baltimore and the Hospital Clinic of Barcelona in Spain between March and June. Older age, hypertension, and pulmonary disease were common among these patients. Systemic or inhaled steroids, often to manage COVID-19–related inflammation, were the most common immunosuppressive agents associated with CAPA. All but 2 of the 20 patients were treated with intravenous antifungal drugs. Three of the patients died.
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