COVID-19 and Aspergillosis
As we approach the fourth World Aspergillosis Day (WAD 2021) we are reminded that last year when it was held at the end of February we were due to host an event to mark the day in southern Switzerland, just over the border from the part of northern Italy. The weekend before WAD 2020 the Italian authorities announced the first dozen cases of COVID-19 in Europe, part of the first signs of the spread of SARS-CoV-2.
The aim of World Aspergillosis Day is to raise awareness of this fungal infection that like several other fungal infections worldwide is often under-diagnosed. Diagnosis of aspergillosis is difficult and requires specialist expertise (eg UK National Aspergillosis Centre, a European Confederation of Medical Mycology Cente of Excellence), but it also frequently occurs alongside much more common illnesses such as asthma, tuberculosis, COPD. Fungal nodules occasionally get mistaken for lung tumours.
Consequently, it seems fitting this year to highlight the impact that aspergillosis, in particular, acute invasive pulmonary aspergillosis, makes on COVID patients. COVID-19-associated pulmonary aspergillosis (CAPA) occurs in patients in critical care, and more than doubles mortality. Once again aspergillosis is the hidden killer but this time COVID-19 will often be recorded as the main cause of death.
A consensus document has been published to warn doctors to look out for signs of aspergillosis in their severely ill patients. The right treatment may help bring down the dreadful mortality figures for people in critical care due to COVID-19.