Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPCOCIO, Tiago AlexandreSIQUEIRA, Lumena Pereira MachadoRICILUCA, Katie Cristina TakeutiGIMENES, Viviane Mazo FaveroANDRADE, Tania Sueli deBENARD, GilMARTINEZ, RobertoBOLLELA, Valdes Roberto2023-10-302023-10-302023BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, v.27, n.4, article ID 102793, 10p, 20231413-8670https://observatorio.fm.usp.br/handle/OPI/56051COVID-19-Associated Pulmonary Aspergillosis (CAPA) is a relatively common complica-tion in patients with severe forms of the disease caused by the SARS-CoV-2 virus. Diag-nosing and confirming CAPA is challenging. In this study, Aspergillus spp. isolation in respiratory specimens from patients with COVID-19 was evaluated for identifying cases of CAPA. In 2020-2021, 17 Aspergillus spp. were isolated from 15 COVID-19 patients admit-ted to a university hospital in Brazil. Patient records were retrospectively reviewed to obtain clinical-epidemiological data and other markers of Aspergillus spp. infection and then compared with the ECMM/ISHAM criteria for defining CAPA. Probable CAPA was defined in 5/10 patients, who had Aspergillus spp. isolated from Bronchoalveolar Lavage (BAL) or a positive galactomannan blood test. Additionally, anti-Aspergillus antibodies were detected in two of these patients, during active or follow-up phases of CAPA. In another seven patients with Aspergillus spp. isolated from tracheobronchial aspirate or sputum, CAPA was presumed, mainly due to deterioration of clinical conditions and new lung imaging suggestive of fungal infection. Antifungal agents to control CAPA, particu-larly voriconazole, were used in 9/15 cases. In cases of probable CAPA and remaining patients, clinical conditions and comorbidities were similar, with lethality being high, at 60% and 71%, respectively. The number of CAPA cases defined by scientific criteria was lower than that assumed in the clinical context. This was largely due to the lack of BAL collection for fungal culture and the non-intensive use of other markers of invasive asper-gillosis. The isolation of Aspergillus spp. in different respiratory specimens should alert clinicians to the diagnosis of CAPA.engopenAccessCAPACOVID-19Matrix-assisted laser desorptionionizationAspergillus sppSARS-CoV-2Invasive aspergillosisarticleCopyright ELSEVIER BRAZIL10.1016/j.bjid.2023.102793Infectious Diseases1678-4391