COVID-19 associated pulmonary aspergillosis: a nationwide survey by the Japanese Respiratory Society

Takazono, Takahiro; Mukae, Hiroshi; Izumikawa, Koichi; Hasegawa, Naoki; Yokoyama, Akihito

The pandemic of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide and resulted in more than 3.5 million people deaths as of June 2021 [1]. Respiratory viruses, such as the influenza virus, cause direct damage to the airway epithelium, enabling Aspergillus to invade airway tissues. SARS-CoV-2 infection can also increase the risk of Aspergillus superinfection, i.e., the so-called COVID-19 associated pulmonary aspergillosis (CAPA), in severe COVID-19 patients [2]. CAPA has become a serious concern worldwide for the management of severe COVID-19 [2]. Several studies have reported a high incidence of CAPA and associated mortality rates in critical COVID-19 patients [3–12]. However, these reports were from limited facilities in the United States (US) or European countries, and epidemiological data from other regions of the world are limited. Therefore, we conducted a nationwide internet questionnaire surveillance study in Japan to obtain large-scale epidemiological data.