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Mortality in critically ill patients with coronavirus disease 2019‐associated pulmonary aspergillosis: A systematic review and meta‐analysis
Author(s) -
Singh Shreya,
Verma Nipun,
Kanaujia Rimjhim,
Chakrabarti Arunaloke,
Rudramurthy Shivaprakash M.
Publication year - 2021
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13328
Subject(s) - medicine , meta analysis , odds ratio , aspergillosis , medline , intensive care medicine , confidence interval , immunology , political science , law
Reports of COVID‐19 associated pulmonary aspergillosis (CAPA) are rising, but the associated mortality and factors affecting it are not well‐characterised. We performed a systematic review including 20 peer‐reviewed English language studies reporting mortality in CAPA published till 18 February 2021from PubMed, Ovid SP, Web of Science, Embase and CINHAL. The pooled mortality in CAPA was 51.2% (95% CI: 43.1–61.1, I 2 = 38%). The leave one out sensitivity analysis and influential case diagnostics revealed one outlier and its exclusion resulted in a mortality estimate of 54% (95% CI: 45–62). Higher odds of mortality: 2.83 (95% CI: 1.8–4.5) were seen in CAPA compared to controls. No significant difference in various subgroups according to the country of study, the continent of study, income category of country and quality of the included study was seen. None of the host risk factors, mycological test results, therapy for COVID‐19 and antifungal therapy affected mortality. Thus, patients with CAPA have a high probability of mortality and early diagnosis with prompt therapy must be ensured to optimally manage these patients. However, more prospective studies with global and multi‐centre coordination may help to address CAPA in a better way.