Factors affecting mortality in covid-19-associated pulmonary aspergillosis: an international ID-IRI study
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info:eu-repo/semantics/openAccessTarih
2024Yazar
Şahin, MeyhaYılmaz, Mesut
Mert, Ali
Emecen, Ahmet Naci
Rahman S. Al Maslamani, Muna A.
Mahmoud A. Hashim, Samar
Ittaman, Ajithkumar Valooparambil
Wadi Al Ramahi, Jamal
Gergely Szabo, Balint
Konopnicki, Deborah
Başkol Elik, Dilşah
Lakatos, Botond
Sipahi, Oğuz Reşat
Khedr, Reham
Jalal, Sabah
Pshenichnaya, Natalia
Magdalena, Dumitru Irina
El Kholy, Amani
Khan, Ejaz Ahmed
Alkan, Sevil
Hakamifard, Atousa
Sincan, Gülden
Esmaoğlu, Aliye
Makek, Mateja Jankovic
Gürbüz, Esra
Liskova, Anna
Albayrak, Ayşe
Stebel, Roman
Ünver Ulusoy, Tülay
Ripon, Rezaul Karim
Moroti, Ruxandra
Dascalu, Cosmin
Rashid, Naveed
Cortegiani, Andrea
Bahadır, Zeynep
Erdem, Hakan
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Şahin, M., Yılmaz, M., Mert, A., Emecen, A. N., Rahman S. Al Maslamani, M. A., Mahmoud A. Hashim, S. ... Erdem, H. (2024). Factors affecting mortality in covid-19-associated pulmonary aspergillosis: an international ID-IRI study. Heliyon, 10(4). http://dx.doi.org/10.1016/j.heliyon.2024.e34325Özet
Background: This study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA). Methods: In this cross-sectional study, data from 23 centers across 15 countries, spanning the period of March 2020 to December 2021, were retrospectively collected. The study population comprised patients who developed invasive pulmonary aspergillosis while being treated for COVID-19 in the intensive care unit. Cox regression and decision tree analyses were used to identify factors associated with mortality in patients with CAPA. Results: A total of 162 patients (males, 65.4 %; median age: 64 [25th–75th: 54.0–73.8] years) were included in the study, of whom 113 died during the 90-day follow-up period. The median duration from CAPA diagnosis to death was 12 (25th–75th: 7–19) days. In the multivariable Cox regression model, an age of ≥65 years (hazard ratio [HR]: 2.05, 95 % confidence interval [CI]: 1.37–3.07), requiring vasopressor therapy at the time of CAPA diagnosis (HR: 1.80, 95 % CI: 1.17–2.76), and receiving renal replacement therapy at the time of CAPA diagnosis (HR: 2.27, 95 % CI: 1.35–3.82) were identified as predictors of mortality. Decision tree analysis revealed that patients with CAPA aged ≥65 years who received corticosteroid treatment for COVID-19 displayed higher mortality rates (estimated rate: 1.6, observed in 46 % of patients). Conclusion: This study concluded that elderly patients with CAPA who receive corticosteroids are at a significantly higher risk of mortality, particularly if they experience multiorgan failure.
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