Characteristics of Patients With or Without Clinical Failure or 30-Day Mortality
| Characteristic, Treatment, or Outcome . | Patients by Clinical Failure, No. (%)a . | P Value . | Patients by 30-d Mortality, No. (%)a . | P Value . | ||
|---|---|---|---|---|---|---|
| Yes (n = 109/209 [53.4%]) . | No (n = 95/209 [46.6%]) . | Yes (n = 79/209[37.8%]) . | No (n = 130/209 [62.2%]) . | |||
| Age, mean (SD; range), y | 68.6 (10.4; 41–90) | 66.0 (13.9; 23–94) | .13 | 68.8 (10.0; 41–90) | 66.8 (13.4; 23–94) | .17 |
| Male sex | 77 (70.6) | 56 (58.9) | .08 | 56 (70.9) | 81 (62.3) | .21 |
| Ward of diagnosis | ||||||
| ICU | 77 (70.6) | 64 (67.4) | .61 | 59 (74.7) | 85 (65.4) | .16 |
| Medical | 32 (29.4) | 31 (32.6) | .61 | 20 (25.3) | 44 (33.9) | .20 |
| Surgical | 0 (0) | 0 (0) | … | 0 (0) | 1 (0.8) | .44 |
| Year of diagnosis | ||||||
| 2018 | 6 (5.5) | 7 (7.4) | .38 | 5 (6.3) | 10 (7.7) | .35 |
| 2019 | 16 (14.7) | 4 (4.2) | .01 | 12 (15.2) | 8 (6.2) | .03 |
| 2020 | 25 (22.9) | 19 (20.0) | .61 | 20 (25.3) | 26 (20.0) | .37 |
| 2021 | 36 (33.0) | 44 (46.3) | .052 | 23 (29.1) | 58 (44.6) | .03 |
| 2022 | 26 (23.8) | 21 (22.1) | .77 | 19 (24.1) | 28 (21.5) | .67 |
| Time from admission to IPA, mean (SD; range), d | 19.7 (16.7; 1–198) | 21.8 (21.6; 1–129) | .45 | 19.9 (17.5; 1–98) | 21.1 (19.8; 1–129) | .65 |
| Comorbid conditions | ||||||
| CCI, mean (SD; range) | 5.6 (0.3; 0–14) | 4.4 (0.2; 0–11) | <.001 | 5.7 (2.8; 0–14) | 4.6 (2.4; 0–11) | .003 |
| Heart disease | 30 (28.9) | 27 (28.4) | .95 | 21 (28) | 37 (28.9) | .89 |
| Hypertension | 69 (65.7) | 56 (59.6) | .37 | 47 (61.8) | 80 (62.9) | .87 |
| Vasculopathy | 21 (20.2) | 21 (22.1) | .74 | 16 (21.3) | 27 (21.1) | .97 |
| Neurological disease | 16 (15.4) | 9 (9.5) | .21 | 9 (12) | 16 (12.5) | .92 |
| Diabetes mellitus | 35 (33.7) | 18 (18.9) | .02 | 28 (37.3) | 26 (20.3) | .008 |
| Dyslipidemia | 30 (28.9) | 27 (28.4) | .95 | 25 (33.3) | 32 (25.0) | .20 |
| Renal failure | 12 (11.5) | 15 (15.8) | .38 | 10 (13.3) | 17 (13.3) | .99 |
| COPD | 24 (23.1) | 22 (23.2) | .99 | 15 (20) | 32 (25.0) | .42 |
| Other pneumopathy | 16 (15.2) | 14 (14.7) | .92 | 13 (17.1) | 19 (14.8) | .67 |
| Previous tuberculosis | 2 (1.9) | 4 (4.2) | .35 | 1 (1.3) | 5 (3.9) | .30 |
| Solid cancer | 31 (29.8) | 22 (23.2) | .29 | 24 (32) | 31 (24.2) | .23 |
| HIV | 1 (0.9) | 1 (1.1) | .95 | 1 (1.3) | 1 (0.8) | .70 |
| Solid organ transplant | 8 (7.7) | 10 (10.5) | .49 | 5 (6.7) | 13 (10.2) | .40 |
| Liver cirrhosis | 10 (9.5) | 4 (4.2) | .14 | 9 (11.8) | 6 (4.7) | .06 |
| Other liver disease | 11 (10.6) | 8 (8.4) | .60 | 8 (10.7) | 11 (8.6) | .62 |
| Autoimmune disease | 11 (10.6) | 10 (10.5) | .99 | 8 (10.7) | 14 (10.9) | .95 |
| Active smoker status | 18 (17.7) | 13 (13.8) | .42 | 10 (13.7) | 23 (18.1) | .69 |
| Concomitant COVID-19 | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| Concomitant influenza | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.5) | .87 |
| Extrinsic factors | ||||||
| IMV | 60 (57.7) | 42 (44.2) | .06 | 46 (61.3) | 57 (44.2) | .02 |
| Steroids | 71 (66.4) | 70 (73.7) | .26 | 53 (68.8) | 90 (69.2) | .95 |
| Steroid duration >3 wk | 28 (28.3) | 32 (34.4) | .36 | 19 (27.1) | 41 (32.8) | .38 |
| Other immunosuppressive therapies | 18 (17.3) | 21 (22.1) | .39 | 14 (18.7) | 25 (19.4) | .90 |
| Tocilizumab | 22 (21.6) | 32 (34.0) | .051 | 36 (28.8) | 18 (23.7) | .43 |
| Active chemotherapy | 11 (10.7) | 7 (7.4) | .42 | 6 (8.0) | 12 (9.4) | .74 |
| Concomitant antibiotic therapy | 93 (88.6) | 76 (84.4) | .40 | 67 (88.2) | 106 (86.2) | .69 |
| Coinfection on respiratory sample | ||||||
| CMV | 25 (24.0) | 22 (24.2) | .98 | 20 (26.7) | 28 (22.8) | .53 |
| Pneumocystis jirovecii | 15 (14.4) | 12 (13.3) | .83 | 13 (17.3) | 14 (11.4) | .24 |
| Pseudomonas aeruginosa | 23 (21.7) | 14 (15.6) | .27 | 16 (20.8) | 23 (18.7) | .72 |
| Clinical presentation | ||||||
| SOFA, mean (SD; range) | 5.8 (4.2; 0–17) | 4.2 (2.4; 0.11) | .02 | 6.1 (4.1; 1–17) | 4.3 (2.9; 0–15) | .009 |
| Septic shock | 18 (18.6) | 15 (15.9) | .64 | 10 (14.3) | 23 (18.3) | .48 |
| Hemoptysis | 3 (2.8) | 2 (2.1) | .77 | 2 (2.5) | 5 (3.9) | .61 |
| Worsening respiratory insufficiency | 90 (82.6) | 75 (78.9) | .51 | 68 (86.1) | 100 (76.9) | .11 |
| Dyspnea | 77 (70.6) | 63 (66.3) | .51 | 56 (70.9) | 88 (67.7) | .63 |
| Persistent fever | 7 (6.4) | 12 (12.6) | .13 | 7 (8.9) | 12 (9.2) | .93 |
| Recurrent fever | 8 (7.3) | 10 (10.5) | .42 | 4 (5.1) | 14 (10.8) | .15 |
| Chest pain | 0 (0) | 3 (3.2) | .06 | 0 (0) | 3 (2.3) | .17 |
| Pleural friction rub | 0 (0) | 1 (1.1) | .28 | 0 (0) | 1 (0.8) | .44 |
| Tracheobronchial pseudomembranes/ulcerations | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.55) | .87 |
| CT findings | ||||||
| Cavitation | 13 (13.4) | 15 (16.5) | .55 | 9 (13.2) | 19 (15.2) | .71 |
| Ground glass | 60 (61.9) | 57 (62.6) | .91 | 42 (61.8) | 77 (61.6) | .98 |
| Consolidation | 78 (80.4) | 79 (86.8) | .24 | 55 (80.9) | 106 (84.8) | .48 |
| Nodules | 31 (31.9) | 31 (34.1) | .76 | 20 (29.4) | 42 (33.6) | .55 |
| Tree in bud | 15 (15.5) | 10 (10.9) | .37 | 7 (10.3) | 18 (14.4) | .42 |
| Halo sign | 3 (3.1) | 3 (3.3) | .94 | 3 (4.4) | 3 (2.4) | .44 |
| Air crescent sign | 0 (0) | 0 (0) | … | 0 (0) | 0 (0) | … |
| Microbiology | ||||||
| Culture positive with respiratory sample (≥1) | 48/109 (44.0) | 47/95 (49.5) | .44 | 39/77 (50.6) | 59/130 (45.4) | .46 |
| Microscopy on BAL | 5/96 (5.2) | 8/84 (9.5) | .26 | 4/69 (5.8) | 11/115 (9.5) | .37 |
| BAL GM positivity (≥1.0) | 65/91 (71.4) | 59/78 (75.6) | .54 | 44/65 (67.7) | 82/108 (75.9) | .24 |
| BAL GM, mean (SD; mean) | 4.28 (1.77; 1.04–7.29) | 4.85(2.50; 1.12–16.8) | .14 | 4.2 (1.6; 1.0–6.8) | 3.5 (2.6; 1.1–7.3) | .18 |
| PCR positivity with respiratory sample (≥1) | 51/74 (68.9) | 58/77 (75.3) | .45 | 32/48 (66.7) | 78/104 (75.0) | .29 |
| PCR positivity with BAL | 43/63 (68.2) | 49/66 (74.2) | .45 | 29/44 (65.9) | 64/87 (73.6) | .36 |
| BAL PCR value, mean (SD; range) | 86 103.8 (282 715.3;132–1 387 200) | 105 420 (356 771.4; 134–1 645 414) | .82 | 117116.3 (330424.2; 262–1387200) | 88 507 (326 258.3; 132–1 645 414) | .76 |
| PCR positivity with BAS | 9/12 (75.0) | 9/12 (75.0) | >.99 | 6/7 (85.7) | 12/17 (70.6) | .44 |
| BAS PCR value, mean (SD; range) | 534 177.6 (978 248.1; 128–2 143 634) | 3847.3 (5419; 237–15 235) | .18 | 848 154.4 (1 160 159; 128–2 143 634) | 5958 (9255.9; 237–28 971) | .03 |
| Serum GM positivity (≥0.5) | 26/99 (26.3) | 14/87 (16.1) | .09 | 22/71 (31) | 19/118 (16.1) | .02 |
| Serum GM, mean (SD; range) | 2.02 (1.78; 0.56–5.85) | 2.37 (2.72; 0.51–10.5) | .63 | 2.2 (1.8; 0.6–5.8) | 2.0 (2.4 ;0.5–10.5) | .75 |
| BDG positivity (≥80.0) | 59/99 (59.6) | 33/87 (37.9) | .003 | 42/72 (58.3) | 51/116 (43.9) | .055 |
| BDG, mean (SD; range) | 405.4 (325.9; 84.3–1623) | 466.7 (405.8; 95.6–1802.9) | .43 | 423.6 (344.7; 96.5–1623) | 424.0 (367.2; 84.3–1802.9) | >.99 |
| Histology | 3/8 (37.5) | 0/0 (0.0) | .12 | 1/4 (25) | 2/9 (22.2) | .91 |
| Diagnosis | ||||||
| CAPA | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| PIPA | 63 (57.8) | 50 (52.6) | .46 | 44 (55.7) | 72 (55.4) | .96 |
| Therapy | ||||||
| Voriconazole (1st line) | 89 (81.7) | 67 (70.5) | .06 | 64 (81) | 96 (73.9) | .24 |
| Isavuconazole (1st line) | 11 (10.1) | 20 (21.1) | .03 | 9 (11.4) | 22 (16.9) | .28 |
| L-Amb (1st line) | 9 (8.3) | 8 (8.4) | .97 | 6 (7.6) | 12 (9.2) | .68 |
| Voriconazole (sole treatment, without switch) | 80 (73.4) | 57 (60.0) | .04 | 57 (72.2) | 83 (63.8) | .22 |
| Isavuconazole (sole treatment, without switch) | 9 (8.3) | 19 (20.0) | .02 | 8 (10.1) | 20 (15.4) | .28 |
| Total duration of therapy, mean (SD; range), d | 19.7 (18.3; 4–114) | 51.0 (56.9; 4–413) | <.001 | 11.5 (5.8; 4–28) | 48.4 (50.6; 4–413) | <.001 |
| Outcomes | ||||||
| LOS, mean (SD; range) d | 40.9 (27.9; 8–172) | 74.0 (55.5; 11–276) | <.001 | 31.8 (18.8; 8–107) | 70.6 (50.7; 8–276) | <.001 |
| Length of ICU stay, mean (SD; range), d | 27.3 (25.9; 1–68) | 35.4 (32.7; 1–138) | .12 | 20.9 (13.9; 1–70) | 38.2 (34.9; 1–168) | .001 |
| Characteristic, Treatment, or Outcome . | Patients by Clinical Failure, No. (%)a . | P Value . | Patients by 30-d Mortality, No. (%)a . | P Value . | ||
|---|---|---|---|---|---|---|
| Yes (n = 109/209 [53.4%]) . | No (n = 95/209 [46.6%]) . | Yes (n = 79/209[37.8%]) . | No (n = 130/209 [62.2%]) . | |||
| Age, mean (SD; range), y | 68.6 (10.4; 41–90) | 66.0 (13.9; 23–94) | .13 | 68.8 (10.0; 41–90) | 66.8 (13.4; 23–94) | .17 |
| Male sex | 77 (70.6) | 56 (58.9) | .08 | 56 (70.9) | 81 (62.3) | .21 |
| Ward of diagnosis | ||||||
| ICU | 77 (70.6) | 64 (67.4) | .61 | 59 (74.7) | 85 (65.4) | .16 |
| Medical | 32 (29.4) | 31 (32.6) | .61 | 20 (25.3) | 44 (33.9) | .20 |
| Surgical | 0 (0) | 0 (0) | … | 0 (0) | 1 (0.8) | .44 |
| Year of diagnosis | ||||||
| 2018 | 6 (5.5) | 7 (7.4) | .38 | 5 (6.3) | 10 (7.7) | .35 |
| 2019 | 16 (14.7) | 4 (4.2) | .01 | 12 (15.2) | 8 (6.2) | .03 |
| 2020 | 25 (22.9) | 19 (20.0) | .61 | 20 (25.3) | 26 (20.0) | .37 |
| 2021 | 36 (33.0) | 44 (46.3) | .052 | 23 (29.1) | 58 (44.6) | .03 |
| 2022 | 26 (23.8) | 21 (22.1) | .77 | 19 (24.1) | 28 (21.5) | .67 |
| Time from admission to IPA, mean (SD; range), d | 19.7 (16.7; 1–198) | 21.8 (21.6; 1–129) | .45 | 19.9 (17.5; 1–98) | 21.1 (19.8; 1–129) | .65 |
| Comorbid conditions | ||||||
| CCI, mean (SD; range) | 5.6 (0.3; 0–14) | 4.4 (0.2; 0–11) | <.001 | 5.7 (2.8; 0–14) | 4.6 (2.4; 0–11) | .003 |
| Heart disease | 30 (28.9) | 27 (28.4) | .95 | 21 (28) | 37 (28.9) | .89 |
| Hypertension | 69 (65.7) | 56 (59.6) | .37 | 47 (61.8) | 80 (62.9) | .87 |
| Vasculopathy | 21 (20.2) | 21 (22.1) | .74 | 16 (21.3) | 27 (21.1) | .97 |
| Neurological disease | 16 (15.4) | 9 (9.5) | .21 | 9 (12) | 16 (12.5) | .92 |
| Diabetes mellitus | 35 (33.7) | 18 (18.9) | .02 | 28 (37.3) | 26 (20.3) | .008 |
| Dyslipidemia | 30 (28.9) | 27 (28.4) | .95 | 25 (33.3) | 32 (25.0) | .20 |
| Renal failure | 12 (11.5) | 15 (15.8) | .38 | 10 (13.3) | 17 (13.3) | .99 |
| COPD | 24 (23.1) | 22 (23.2) | .99 | 15 (20) | 32 (25.0) | .42 |
| Other pneumopathy | 16 (15.2) | 14 (14.7) | .92 | 13 (17.1) | 19 (14.8) | .67 |
| Previous tuberculosis | 2 (1.9) | 4 (4.2) | .35 | 1 (1.3) | 5 (3.9) | .30 |
| Solid cancer | 31 (29.8) | 22 (23.2) | .29 | 24 (32) | 31 (24.2) | .23 |
| HIV | 1 (0.9) | 1 (1.1) | .95 | 1 (1.3) | 1 (0.8) | .70 |
| Solid organ transplant | 8 (7.7) | 10 (10.5) | .49 | 5 (6.7) | 13 (10.2) | .40 |
| Liver cirrhosis | 10 (9.5) | 4 (4.2) | .14 | 9 (11.8) | 6 (4.7) | .06 |
| Other liver disease | 11 (10.6) | 8 (8.4) | .60 | 8 (10.7) | 11 (8.6) | .62 |
| Autoimmune disease | 11 (10.6) | 10 (10.5) | .99 | 8 (10.7) | 14 (10.9) | .95 |
| Active smoker status | 18 (17.7) | 13 (13.8) | .42 | 10 (13.7) | 23 (18.1) | .69 |
| Concomitant COVID-19 | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| Concomitant influenza | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.5) | .87 |
| Extrinsic factors | ||||||
| IMV | 60 (57.7) | 42 (44.2) | .06 | 46 (61.3) | 57 (44.2) | .02 |
| Steroids | 71 (66.4) | 70 (73.7) | .26 | 53 (68.8) | 90 (69.2) | .95 |
| Steroid duration >3 wk | 28 (28.3) | 32 (34.4) | .36 | 19 (27.1) | 41 (32.8) | .38 |
| Other immunosuppressive therapies | 18 (17.3) | 21 (22.1) | .39 | 14 (18.7) | 25 (19.4) | .90 |
| Tocilizumab | 22 (21.6) | 32 (34.0) | .051 | 36 (28.8) | 18 (23.7) | .43 |
| Active chemotherapy | 11 (10.7) | 7 (7.4) | .42 | 6 (8.0) | 12 (9.4) | .74 |
| Concomitant antibiotic therapy | 93 (88.6) | 76 (84.4) | .40 | 67 (88.2) | 106 (86.2) | .69 |
| Coinfection on respiratory sample | ||||||
| CMV | 25 (24.0) | 22 (24.2) | .98 | 20 (26.7) | 28 (22.8) | .53 |
| Pneumocystis jirovecii | 15 (14.4) | 12 (13.3) | .83 | 13 (17.3) | 14 (11.4) | .24 |
| Pseudomonas aeruginosa | 23 (21.7) | 14 (15.6) | .27 | 16 (20.8) | 23 (18.7) | .72 |
| Clinical presentation | ||||||
| SOFA, mean (SD; range) | 5.8 (4.2; 0–17) | 4.2 (2.4; 0.11) | .02 | 6.1 (4.1; 1–17) | 4.3 (2.9; 0–15) | .009 |
| Septic shock | 18 (18.6) | 15 (15.9) | .64 | 10 (14.3) | 23 (18.3) | .48 |
| Hemoptysis | 3 (2.8) | 2 (2.1) | .77 | 2 (2.5) | 5 (3.9) | .61 |
| Worsening respiratory insufficiency | 90 (82.6) | 75 (78.9) | .51 | 68 (86.1) | 100 (76.9) | .11 |
| Dyspnea | 77 (70.6) | 63 (66.3) | .51 | 56 (70.9) | 88 (67.7) | .63 |
| Persistent fever | 7 (6.4) | 12 (12.6) | .13 | 7 (8.9) | 12 (9.2) | .93 |
| Recurrent fever | 8 (7.3) | 10 (10.5) | .42 | 4 (5.1) | 14 (10.8) | .15 |
| Chest pain | 0 (0) | 3 (3.2) | .06 | 0 (0) | 3 (2.3) | .17 |
| Pleural friction rub | 0 (0) | 1 (1.1) | .28 | 0 (0) | 1 (0.8) | .44 |
| Tracheobronchial pseudomembranes/ulcerations | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.55) | .87 |
| CT findings | ||||||
| Cavitation | 13 (13.4) | 15 (16.5) | .55 | 9 (13.2) | 19 (15.2) | .71 |
| Ground glass | 60 (61.9) | 57 (62.6) | .91 | 42 (61.8) | 77 (61.6) | .98 |
| Consolidation | 78 (80.4) | 79 (86.8) | .24 | 55 (80.9) | 106 (84.8) | .48 |
| Nodules | 31 (31.9) | 31 (34.1) | .76 | 20 (29.4) | 42 (33.6) | .55 |
| Tree in bud | 15 (15.5) | 10 (10.9) | .37 | 7 (10.3) | 18 (14.4) | .42 |
| Halo sign | 3 (3.1) | 3 (3.3) | .94 | 3 (4.4) | 3 (2.4) | .44 |
| Air crescent sign | 0 (0) | 0 (0) | … | 0 (0) | 0 (0) | … |
| Microbiology | ||||||
| Culture positive with respiratory sample (≥1) | 48/109 (44.0) | 47/95 (49.5) | .44 | 39/77 (50.6) | 59/130 (45.4) | .46 |
| Microscopy on BAL | 5/96 (5.2) | 8/84 (9.5) | .26 | 4/69 (5.8) | 11/115 (9.5) | .37 |
| BAL GM positivity (≥1.0) | 65/91 (71.4) | 59/78 (75.6) | .54 | 44/65 (67.7) | 82/108 (75.9) | .24 |
| BAL GM, mean (SD; mean) | 4.28 (1.77; 1.04–7.29) | 4.85(2.50; 1.12–16.8) | .14 | 4.2 (1.6; 1.0–6.8) | 3.5 (2.6; 1.1–7.3) | .18 |
| PCR positivity with respiratory sample (≥1) | 51/74 (68.9) | 58/77 (75.3) | .45 | 32/48 (66.7) | 78/104 (75.0) | .29 |
| PCR positivity with BAL | 43/63 (68.2) | 49/66 (74.2) | .45 | 29/44 (65.9) | 64/87 (73.6) | .36 |
| BAL PCR value, mean (SD; range) | 86 103.8 (282 715.3;132–1 387 200) | 105 420 (356 771.4; 134–1 645 414) | .82 | 117116.3 (330424.2; 262–1387200) | 88 507 (326 258.3; 132–1 645 414) | .76 |
| PCR positivity with BAS | 9/12 (75.0) | 9/12 (75.0) | >.99 | 6/7 (85.7) | 12/17 (70.6) | .44 |
| BAS PCR value, mean (SD; range) | 534 177.6 (978 248.1; 128–2 143 634) | 3847.3 (5419; 237–15 235) | .18 | 848 154.4 (1 160 159; 128–2 143 634) | 5958 (9255.9; 237–28 971) | .03 |
| Serum GM positivity (≥0.5) | 26/99 (26.3) | 14/87 (16.1) | .09 | 22/71 (31) | 19/118 (16.1) | .02 |
| Serum GM, mean (SD; range) | 2.02 (1.78; 0.56–5.85) | 2.37 (2.72; 0.51–10.5) | .63 | 2.2 (1.8; 0.6–5.8) | 2.0 (2.4 ;0.5–10.5) | .75 |
| BDG positivity (≥80.0) | 59/99 (59.6) | 33/87 (37.9) | .003 | 42/72 (58.3) | 51/116 (43.9) | .055 |
| BDG, mean (SD; range) | 405.4 (325.9; 84.3–1623) | 466.7 (405.8; 95.6–1802.9) | .43 | 423.6 (344.7; 96.5–1623) | 424.0 (367.2; 84.3–1802.9) | >.99 |
| Histology | 3/8 (37.5) | 0/0 (0.0) | .12 | 1/4 (25) | 2/9 (22.2) | .91 |
| Diagnosis | ||||||
| CAPA | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| PIPA | 63 (57.8) | 50 (52.6) | .46 | 44 (55.7) | 72 (55.4) | .96 |
| Therapy | ||||||
| Voriconazole (1st line) | 89 (81.7) | 67 (70.5) | .06 | 64 (81) | 96 (73.9) | .24 |
| Isavuconazole (1st line) | 11 (10.1) | 20 (21.1) | .03 | 9 (11.4) | 22 (16.9) | .28 |
| L-Amb (1st line) | 9 (8.3) | 8 (8.4) | .97 | 6 (7.6) | 12 (9.2) | .68 |
| Voriconazole (sole treatment, without switch) | 80 (73.4) | 57 (60.0) | .04 | 57 (72.2) | 83 (63.8) | .22 |
| Isavuconazole (sole treatment, without switch) | 9 (8.3) | 19 (20.0) | .02 | 8 (10.1) | 20 (15.4) | .28 |
| Total duration of therapy, mean (SD; range), d | 19.7 (18.3; 4–114) | 51.0 (56.9; 4–413) | <.001 | 11.5 (5.8; 4–28) | 48.4 (50.6; 4–413) | <.001 |
| Outcomes | ||||||
| LOS, mean (SD; range) d | 40.9 (27.9; 8–172) | 74.0 (55.5; 11–276) | <.001 | 31.8 (18.8; 8–107) | 70.6 (50.7; 8–276) | <.001 |
| Length of ICU stay, mean (SD; range), d | 27.3 (25.9; 1–68) | 35.4 (32.7; 1–138) | .12 | 20.9 (13.9; 1–70) | 38.2 (34.9; 1–168) | .001 |
Abbreviations: BAL, bronchoalveolar lavage; BAS, bronchoaspirate; BDG, β-D-glucan; CAPA, COVID-19–associated pulmonary aspergillosis; CCI, Charlson Comorbidity Index; CMV, cytomegalovirus; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; CT, computed tomographic; GM, galactomannan; HIV, human immunodeficiency virus; ICU, intensive care unit; IMV, invasive mechanical ventilation; IPA, invasive pulmonary aspergillosis; L-Amb, liposomal amphotericin; LOS, length of hospital stay; PCR, polymerase chain reaction; PIPA, putative IPA; SOFA, Sequential Organ Failure Assessment.
aData represent no. (%) of patients unless otherwise specified.
Characteristics of Patients With or Without Clinical Failure or 30-Day Mortality
| Characteristic, Treatment, or Outcome . | Patients by Clinical Failure, No. (%)a . | P Value . | Patients by 30-d Mortality, No. (%)a . | P Value . | ||
|---|---|---|---|---|---|---|
| Yes (n = 109/209 [53.4%]) . | No (n = 95/209 [46.6%]) . | Yes (n = 79/209[37.8%]) . | No (n = 130/209 [62.2%]) . | |||
| Age, mean (SD; range), y | 68.6 (10.4; 41–90) | 66.0 (13.9; 23–94) | .13 | 68.8 (10.0; 41–90) | 66.8 (13.4; 23–94) | .17 |
| Male sex | 77 (70.6) | 56 (58.9) | .08 | 56 (70.9) | 81 (62.3) | .21 |
| Ward of diagnosis | ||||||
| ICU | 77 (70.6) | 64 (67.4) | .61 | 59 (74.7) | 85 (65.4) | .16 |
| Medical | 32 (29.4) | 31 (32.6) | .61 | 20 (25.3) | 44 (33.9) | .20 |
| Surgical | 0 (0) | 0 (0) | … | 0 (0) | 1 (0.8) | .44 |
| Year of diagnosis | ||||||
| 2018 | 6 (5.5) | 7 (7.4) | .38 | 5 (6.3) | 10 (7.7) | .35 |
| 2019 | 16 (14.7) | 4 (4.2) | .01 | 12 (15.2) | 8 (6.2) | .03 |
| 2020 | 25 (22.9) | 19 (20.0) | .61 | 20 (25.3) | 26 (20.0) | .37 |
| 2021 | 36 (33.0) | 44 (46.3) | .052 | 23 (29.1) | 58 (44.6) | .03 |
| 2022 | 26 (23.8) | 21 (22.1) | .77 | 19 (24.1) | 28 (21.5) | .67 |
| Time from admission to IPA, mean (SD; range), d | 19.7 (16.7; 1–198) | 21.8 (21.6; 1–129) | .45 | 19.9 (17.5; 1–98) | 21.1 (19.8; 1–129) | .65 |
| Comorbid conditions | ||||||
| CCI, mean (SD; range) | 5.6 (0.3; 0–14) | 4.4 (0.2; 0–11) | <.001 | 5.7 (2.8; 0–14) | 4.6 (2.4; 0–11) | .003 |
| Heart disease | 30 (28.9) | 27 (28.4) | .95 | 21 (28) | 37 (28.9) | .89 |
| Hypertension | 69 (65.7) | 56 (59.6) | .37 | 47 (61.8) | 80 (62.9) | .87 |
| Vasculopathy | 21 (20.2) | 21 (22.1) | .74 | 16 (21.3) | 27 (21.1) | .97 |
| Neurological disease | 16 (15.4) | 9 (9.5) | .21 | 9 (12) | 16 (12.5) | .92 |
| Diabetes mellitus | 35 (33.7) | 18 (18.9) | .02 | 28 (37.3) | 26 (20.3) | .008 |
| Dyslipidemia | 30 (28.9) | 27 (28.4) | .95 | 25 (33.3) | 32 (25.0) | .20 |
| Renal failure | 12 (11.5) | 15 (15.8) | .38 | 10 (13.3) | 17 (13.3) | .99 |
| COPD | 24 (23.1) | 22 (23.2) | .99 | 15 (20) | 32 (25.0) | .42 |
| Other pneumopathy | 16 (15.2) | 14 (14.7) | .92 | 13 (17.1) | 19 (14.8) | .67 |
| Previous tuberculosis | 2 (1.9) | 4 (4.2) | .35 | 1 (1.3) | 5 (3.9) | .30 |
| Solid cancer | 31 (29.8) | 22 (23.2) | .29 | 24 (32) | 31 (24.2) | .23 |
| HIV | 1 (0.9) | 1 (1.1) | .95 | 1 (1.3) | 1 (0.8) | .70 |
| Solid organ transplant | 8 (7.7) | 10 (10.5) | .49 | 5 (6.7) | 13 (10.2) | .40 |
| Liver cirrhosis | 10 (9.5) | 4 (4.2) | .14 | 9 (11.8) | 6 (4.7) | .06 |
| Other liver disease | 11 (10.6) | 8 (8.4) | .60 | 8 (10.7) | 11 (8.6) | .62 |
| Autoimmune disease | 11 (10.6) | 10 (10.5) | .99 | 8 (10.7) | 14 (10.9) | .95 |
| Active smoker status | 18 (17.7) | 13 (13.8) | .42 | 10 (13.7) | 23 (18.1) | .69 |
| Concomitant COVID-19 | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| Concomitant influenza | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.5) | .87 |
| Extrinsic factors | ||||||
| IMV | 60 (57.7) | 42 (44.2) | .06 | 46 (61.3) | 57 (44.2) | .02 |
| Steroids | 71 (66.4) | 70 (73.7) | .26 | 53 (68.8) | 90 (69.2) | .95 |
| Steroid duration >3 wk | 28 (28.3) | 32 (34.4) | .36 | 19 (27.1) | 41 (32.8) | .38 |
| Other immunosuppressive therapies | 18 (17.3) | 21 (22.1) | .39 | 14 (18.7) | 25 (19.4) | .90 |
| Tocilizumab | 22 (21.6) | 32 (34.0) | .051 | 36 (28.8) | 18 (23.7) | .43 |
| Active chemotherapy | 11 (10.7) | 7 (7.4) | .42 | 6 (8.0) | 12 (9.4) | .74 |
| Concomitant antibiotic therapy | 93 (88.6) | 76 (84.4) | .40 | 67 (88.2) | 106 (86.2) | .69 |
| Coinfection on respiratory sample | ||||||
| CMV | 25 (24.0) | 22 (24.2) | .98 | 20 (26.7) | 28 (22.8) | .53 |
| Pneumocystis jirovecii | 15 (14.4) | 12 (13.3) | .83 | 13 (17.3) | 14 (11.4) | .24 |
| Pseudomonas aeruginosa | 23 (21.7) | 14 (15.6) | .27 | 16 (20.8) | 23 (18.7) | .72 |
| Clinical presentation | ||||||
| SOFA, mean (SD; range) | 5.8 (4.2; 0–17) | 4.2 (2.4; 0.11) | .02 | 6.1 (4.1; 1–17) | 4.3 (2.9; 0–15) | .009 |
| Septic shock | 18 (18.6) | 15 (15.9) | .64 | 10 (14.3) | 23 (18.3) | .48 |
| Hemoptysis | 3 (2.8) | 2 (2.1) | .77 | 2 (2.5) | 5 (3.9) | .61 |
| Worsening respiratory insufficiency | 90 (82.6) | 75 (78.9) | .51 | 68 (86.1) | 100 (76.9) | .11 |
| Dyspnea | 77 (70.6) | 63 (66.3) | .51 | 56 (70.9) | 88 (67.7) | .63 |
| Persistent fever | 7 (6.4) | 12 (12.6) | .13 | 7 (8.9) | 12 (9.2) | .93 |
| Recurrent fever | 8 (7.3) | 10 (10.5) | .42 | 4 (5.1) | 14 (10.8) | .15 |
| Chest pain | 0 (0) | 3 (3.2) | .06 | 0 (0) | 3 (2.3) | .17 |
| Pleural friction rub | 0 (0) | 1 (1.1) | .28 | 0 (0) | 1 (0.8) | .44 |
| Tracheobronchial pseudomembranes/ulcerations | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.55) | .87 |
| CT findings | ||||||
| Cavitation | 13 (13.4) | 15 (16.5) | .55 | 9 (13.2) | 19 (15.2) | .71 |
| Ground glass | 60 (61.9) | 57 (62.6) | .91 | 42 (61.8) | 77 (61.6) | .98 |
| Consolidation | 78 (80.4) | 79 (86.8) | .24 | 55 (80.9) | 106 (84.8) | .48 |
| Nodules | 31 (31.9) | 31 (34.1) | .76 | 20 (29.4) | 42 (33.6) | .55 |
| Tree in bud | 15 (15.5) | 10 (10.9) | .37 | 7 (10.3) | 18 (14.4) | .42 |
| Halo sign | 3 (3.1) | 3 (3.3) | .94 | 3 (4.4) | 3 (2.4) | .44 |
| Air crescent sign | 0 (0) | 0 (0) | … | 0 (0) | 0 (0) | … |
| Microbiology | ||||||
| Culture positive with respiratory sample (≥1) | 48/109 (44.0) | 47/95 (49.5) | .44 | 39/77 (50.6) | 59/130 (45.4) | .46 |
| Microscopy on BAL | 5/96 (5.2) | 8/84 (9.5) | .26 | 4/69 (5.8) | 11/115 (9.5) | .37 |
| BAL GM positivity (≥1.0) | 65/91 (71.4) | 59/78 (75.6) | .54 | 44/65 (67.7) | 82/108 (75.9) | .24 |
| BAL GM, mean (SD; mean) | 4.28 (1.77; 1.04–7.29) | 4.85(2.50; 1.12–16.8) | .14 | 4.2 (1.6; 1.0–6.8) | 3.5 (2.6; 1.1–7.3) | .18 |
| PCR positivity with respiratory sample (≥1) | 51/74 (68.9) | 58/77 (75.3) | .45 | 32/48 (66.7) | 78/104 (75.0) | .29 |
| PCR positivity with BAL | 43/63 (68.2) | 49/66 (74.2) | .45 | 29/44 (65.9) | 64/87 (73.6) | .36 |
| BAL PCR value, mean (SD; range) | 86 103.8 (282 715.3;132–1 387 200) | 105 420 (356 771.4; 134–1 645 414) | .82 | 117116.3 (330424.2; 262–1387200) | 88 507 (326 258.3; 132–1 645 414) | .76 |
| PCR positivity with BAS | 9/12 (75.0) | 9/12 (75.0) | >.99 | 6/7 (85.7) | 12/17 (70.6) | .44 |
| BAS PCR value, mean (SD; range) | 534 177.6 (978 248.1; 128–2 143 634) | 3847.3 (5419; 237–15 235) | .18 | 848 154.4 (1 160 159; 128–2 143 634) | 5958 (9255.9; 237–28 971) | .03 |
| Serum GM positivity (≥0.5) | 26/99 (26.3) | 14/87 (16.1) | .09 | 22/71 (31) | 19/118 (16.1) | .02 |
| Serum GM, mean (SD; range) | 2.02 (1.78; 0.56–5.85) | 2.37 (2.72; 0.51–10.5) | .63 | 2.2 (1.8; 0.6–5.8) | 2.0 (2.4 ;0.5–10.5) | .75 |
| BDG positivity (≥80.0) | 59/99 (59.6) | 33/87 (37.9) | .003 | 42/72 (58.3) | 51/116 (43.9) | .055 |
| BDG, mean (SD; range) | 405.4 (325.9; 84.3–1623) | 466.7 (405.8; 95.6–1802.9) | .43 | 423.6 (344.7; 96.5–1623) | 424.0 (367.2; 84.3–1802.9) | >.99 |
| Histology | 3/8 (37.5) | 0/0 (0.0) | .12 | 1/4 (25) | 2/9 (22.2) | .91 |
| Diagnosis | ||||||
| CAPA | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| PIPA | 63 (57.8) | 50 (52.6) | .46 | 44 (55.7) | 72 (55.4) | .96 |
| Therapy | ||||||
| Voriconazole (1st line) | 89 (81.7) | 67 (70.5) | .06 | 64 (81) | 96 (73.9) | .24 |
| Isavuconazole (1st line) | 11 (10.1) | 20 (21.1) | .03 | 9 (11.4) | 22 (16.9) | .28 |
| L-Amb (1st line) | 9 (8.3) | 8 (8.4) | .97 | 6 (7.6) | 12 (9.2) | .68 |
| Voriconazole (sole treatment, without switch) | 80 (73.4) | 57 (60.0) | .04 | 57 (72.2) | 83 (63.8) | .22 |
| Isavuconazole (sole treatment, without switch) | 9 (8.3) | 19 (20.0) | .02 | 8 (10.1) | 20 (15.4) | .28 |
| Total duration of therapy, mean (SD; range), d | 19.7 (18.3; 4–114) | 51.0 (56.9; 4–413) | <.001 | 11.5 (5.8; 4–28) | 48.4 (50.6; 4–413) | <.001 |
| Outcomes | ||||||
| LOS, mean (SD; range) d | 40.9 (27.9; 8–172) | 74.0 (55.5; 11–276) | <.001 | 31.8 (18.8; 8–107) | 70.6 (50.7; 8–276) | <.001 |
| Length of ICU stay, mean (SD; range), d | 27.3 (25.9; 1–68) | 35.4 (32.7; 1–138) | .12 | 20.9 (13.9; 1–70) | 38.2 (34.9; 1–168) | .001 |
| Characteristic, Treatment, or Outcome . | Patients by Clinical Failure, No. (%)a . | P Value . | Patients by 30-d Mortality, No. (%)a . | P Value . | ||
|---|---|---|---|---|---|---|
| Yes (n = 109/209 [53.4%]) . | No (n = 95/209 [46.6%]) . | Yes (n = 79/209[37.8%]) . | No (n = 130/209 [62.2%]) . | |||
| Age, mean (SD; range), y | 68.6 (10.4; 41–90) | 66.0 (13.9; 23–94) | .13 | 68.8 (10.0; 41–90) | 66.8 (13.4; 23–94) | .17 |
| Male sex | 77 (70.6) | 56 (58.9) | .08 | 56 (70.9) | 81 (62.3) | .21 |
| Ward of diagnosis | ||||||
| ICU | 77 (70.6) | 64 (67.4) | .61 | 59 (74.7) | 85 (65.4) | .16 |
| Medical | 32 (29.4) | 31 (32.6) | .61 | 20 (25.3) | 44 (33.9) | .20 |
| Surgical | 0 (0) | 0 (0) | … | 0 (0) | 1 (0.8) | .44 |
| Year of diagnosis | ||||||
| 2018 | 6 (5.5) | 7 (7.4) | .38 | 5 (6.3) | 10 (7.7) | .35 |
| 2019 | 16 (14.7) | 4 (4.2) | .01 | 12 (15.2) | 8 (6.2) | .03 |
| 2020 | 25 (22.9) | 19 (20.0) | .61 | 20 (25.3) | 26 (20.0) | .37 |
| 2021 | 36 (33.0) | 44 (46.3) | .052 | 23 (29.1) | 58 (44.6) | .03 |
| 2022 | 26 (23.8) | 21 (22.1) | .77 | 19 (24.1) | 28 (21.5) | .67 |
| Time from admission to IPA, mean (SD; range), d | 19.7 (16.7; 1–198) | 21.8 (21.6; 1–129) | .45 | 19.9 (17.5; 1–98) | 21.1 (19.8; 1–129) | .65 |
| Comorbid conditions | ||||||
| CCI, mean (SD; range) | 5.6 (0.3; 0–14) | 4.4 (0.2; 0–11) | <.001 | 5.7 (2.8; 0–14) | 4.6 (2.4; 0–11) | .003 |
| Heart disease | 30 (28.9) | 27 (28.4) | .95 | 21 (28) | 37 (28.9) | .89 |
| Hypertension | 69 (65.7) | 56 (59.6) | .37 | 47 (61.8) | 80 (62.9) | .87 |
| Vasculopathy | 21 (20.2) | 21 (22.1) | .74 | 16 (21.3) | 27 (21.1) | .97 |
| Neurological disease | 16 (15.4) | 9 (9.5) | .21 | 9 (12) | 16 (12.5) | .92 |
| Diabetes mellitus | 35 (33.7) | 18 (18.9) | .02 | 28 (37.3) | 26 (20.3) | .008 |
| Dyslipidemia | 30 (28.9) | 27 (28.4) | .95 | 25 (33.3) | 32 (25.0) | .20 |
| Renal failure | 12 (11.5) | 15 (15.8) | .38 | 10 (13.3) | 17 (13.3) | .99 |
| COPD | 24 (23.1) | 22 (23.2) | .99 | 15 (20) | 32 (25.0) | .42 |
| Other pneumopathy | 16 (15.2) | 14 (14.7) | .92 | 13 (17.1) | 19 (14.8) | .67 |
| Previous tuberculosis | 2 (1.9) | 4 (4.2) | .35 | 1 (1.3) | 5 (3.9) | .30 |
| Solid cancer | 31 (29.8) | 22 (23.2) | .29 | 24 (32) | 31 (24.2) | .23 |
| HIV | 1 (0.9) | 1 (1.1) | .95 | 1 (1.3) | 1 (0.8) | .70 |
| Solid organ transplant | 8 (7.7) | 10 (10.5) | .49 | 5 (6.7) | 13 (10.2) | .40 |
| Liver cirrhosis | 10 (9.5) | 4 (4.2) | .14 | 9 (11.8) | 6 (4.7) | .06 |
| Other liver disease | 11 (10.6) | 8 (8.4) | .60 | 8 (10.7) | 11 (8.6) | .62 |
| Autoimmune disease | 11 (10.6) | 10 (10.5) | .99 | 8 (10.7) | 14 (10.9) | .95 |
| Active smoker status | 18 (17.7) | 13 (13.8) | .42 | 10 (13.7) | 23 (18.1) | .69 |
| Concomitant COVID-19 | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| Concomitant influenza | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.5) | .87 |
| Extrinsic factors | ||||||
| IMV | 60 (57.7) | 42 (44.2) | .06 | 46 (61.3) | 57 (44.2) | .02 |
| Steroids | 71 (66.4) | 70 (73.7) | .26 | 53 (68.8) | 90 (69.2) | .95 |
| Steroid duration >3 wk | 28 (28.3) | 32 (34.4) | .36 | 19 (27.1) | 41 (32.8) | .38 |
| Other immunosuppressive therapies | 18 (17.3) | 21 (22.1) | .39 | 14 (18.7) | 25 (19.4) | .90 |
| Tocilizumab | 22 (21.6) | 32 (34.0) | .051 | 36 (28.8) | 18 (23.7) | .43 |
| Active chemotherapy | 11 (10.7) | 7 (7.4) | .42 | 6 (8.0) | 12 (9.4) | .74 |
| Concomitant antibiotic therapy | 93 (88.6) | 76 (84.4) | .40 | 67 (88.2) | 106 (86.2) | .69 |
| Coinfection on respiratory sample | ||||||
| CMV | 25 (24.0) | 22 (24.2) | .98 | 20 (26.7) | 28 (22.8) | .53 |
| Pneumocystis jirovecii | 15 (14.4) | 12 (13.3) | .83 | 13 (17.3) | 14 (11.4) | .24 |
| Pseudomonas aeruginosa | 23 (21.7) | 14 (15.6) | .27 | 16 (20.8) | 23 (18.7) | .72 |
| Clinical presentation | ||||||
| SOFA, mean (SD; range) | 5.8 (4.2; 0–17) | 4.2 (2.4; 0.11) | .02 | 6.1 (4.1; 1–17) | 4.3 (2.9; 0–15) | .009 |
| Septic shock | 18 (18.6) | 15 (15.9) | .64 | 10 (14.3) | 23 (18.3) | .48 |
| Hemoptysis | 3 (2.8) | 2 (2.1) | .77 | 2 (2.5) | 5 (3.9) | .61 |
| Worsening respiratory insufficiency | 90 (82.6) | 75 (78.9) | .51 | 68 (86.1) | 100 (76.9) | .11 |
| Dyspnea | 77 (70.6) | 63 (66.3) | .51 | 56 (70.9) | 88 (67.7) | .63 |
| Persistent fever | 7 (6.4) | 12 (12.6) | .13 | 7 (8.9) | 12 (9.2) | .93 |
| Recurrent fever | 8 (7.3) | 10 (10.5) | .42 | 4 (5.1) | 14 (10.8) | .15 |
| Chest pain | 0 (0) | 3 (3.2) | .06 | 0 (0) | 3 (2.3) | .17 |
| Pleural friction rub | 0 (0) | 1 (1.1) | .28 | 0 (0) | 1 (0.8) | .44 |
| Tracheobronchial pseudomembranes/ulcerations | 1 (0.9) | 2 (2.1) | .48 | 1 (1.3) | 2 (1.55) | .87 |
| CT findings | ||||||
| Cavitation | 13 (13.4) | 15 (16.5) | .55 | 9 (13.2) | 19 (15.2) | .71 |
| Ground glass | 60 (61.9) | 57 (62.6) | .91 | 42 (61.8) | 77 (61.6) | .98 |
| Consolidation | 78 (80.4) | 79 (86.8) | .24 | 55 (80.9) | 106 (84.8) | .48 |
| Nodules | 31 (31.9) | 31 (34.1) | .76 | 20 (29.4) | 42 (33.6) | .55 |
| Tree in bud | 15 (15.5) | 10 (10.9) | .37 | 7 (10.3) | 18 (14.4) | .42 |
| Halo sign | 3 (3.1) | 3 (3.3) | .94 | 3 (4.4) | 3 (2.4) | .44 |
| Air crescent sign | 0 (0) | 0 (0) | … | 0 (0) | 0 (0) | … |
| Microbiology | ||||||
| Culture positive with respiratory sample (≥1) | 48/109 (44.0) | 47/95 (49.5) | .44 | 39/77 (50.6) | 59/130 (45.4) | .46 |
| Microscopy on BAL | 5/96 (5.2) | 8/84 (9.5) | .26 | 4/69 (5.8) | 11/115 (9.5) | .37 |
| BAL GM positivity (≥1.0) | 65/91 (71.4) | 59/78 (75.6) | .54 | 44/65 (67.7) | 82/108 (75.9) | .24 |
| BAL GM, mean (SD; mean) | 4.28 (1.77; 1.04–7.29) | 4.85(2.50; 1.12–16.8) | .14 | 4.2 (1.6; 1.0–6.8) | 3.5 (2.6; 1.1–7.3) | .18 |
| PCR positivity with respiratory sample (≥1) | 51/74 (68.9) | 58/77 (75.3) | .45 | 32/48 (66.7) | 78/104 (75.0) | .29 |
| PCR positivity with BAL | 43/63 (68.2) | 49/66 (74.2) | .45 | 29/44 (65.9) | 64/87 (73.6) | .36 |
| BAL PCR value, mean (SD; range) | 86 103.8 (282 715.3;132–1 387 200) | 105 420 (356 771.4; 134–1 645 414) | .82 | 117116.3 (330424.2; 262–1387200) | 88 507 (326 258.3; 132–1 645 414) | .76 |
| PCR positivity with BAS | 9/12 (75.0) | 9/12 (75.0) | >.99 | 6/7 (85.7) | 12/17 (70.6) | .44 |
| BAS PCR value, mean (SD; range) | 534 177.6 (978 248.1; 128–2 143 634) | 3847.3 (5419; 237–15 235) | .18 | 848 154.4 (1 160 159; 128–2 143 634) | 5958 (9255.9; 237–28 971) | .03 |
| Serum GM positivity (≥0.5) | 26/99 (26.3) | 14/87 (16.1) | .09 | 22/71 (31) | 19/118 (16.1) | .02 |
| Serum GM, mean (SD; range) | 2.02 (1.78; 0.56–5.85) | 2.37 (2.72; 0.51–10.5) | .63 | 2.2 (1.8; 0.6–5.8) | 2.0 (2.4 ;0.5–10.5) | .75 |
| BDG positivity (≥80.0) | 59/99 (59.6) | 33/87 (37.9) | .003 | 42/72 (58.3) | 51/116 (43.9) | .055 |
| BDG, mean (SD; range) | 405.4 (325.9; 84.3–1623) | 466.7 (405.8; 95.6–1802.9) | .43 | 423.6 (344.7; 96.5–1623) | 424.0 (367.2; 84.3–1802.9) | >.99 |
| Histology | 3/8 (37.5) | 0/0 (0.0) | .12 | 1/4 (25) | 2/9 (22.2) | .91 |
| Diagnosis | ||||||
| CAPA | 46 (42.2) | 45 (47.4) | .46 | 35 (44.3) | 58 (44.6) | .96 |
| PIPA | 63 (57.8) | 50 (52.6) | .46 | 44 (55.7) | 72 (55.4) | .96 |
| Therapy | ||||||
| Voriconazole (1st line) | 89 (81.7) | 67 (70.5) | .06 | 64 (81) | 96 (73.9) | .24 |
| Isavuconazole (1st line) | 11 (10.1) | 20 (21.1) | .03 | 9 (11.4) | 22 (16.9) | .28 |
| L-Amb (1st line) | 9 (8.3) | 8 (8.4) | .97 | 6 (7.6) | 12 (9.2) | .68 |
| Voriconazole (sole treatment, without switch) | 80 (73.4) | 57 (60.0) | .04 | 57 (72.2) | 83 (63.8) | .22 |
| Isavuconazole (sole treatment, without switch) | 9 (8.3) | 19 (20.0) | .02 | 8 (10.1) | 20 (15.4) | .28 |
| Total duration of therapy, mean (SD; range), d | 19.7 (18.3; 4–114) | 51.0 (56.9; 4–413) | <.001 | 11.5 (5.8; 4–28) | 48.4 (50.6; 4–413) | <.001 |
| Outcomes | ||||||
| LOS, mean (SD; range) d | 40.9 (27.9; 8–172) | 74.0 (55.5; 11–276) | <.001 | 31.8 (18.8; 8–107) | 70.6 (50.7; 8–276) | <.001 |
| Length of ICU stay, mean (SD; range), d | 27.3 (25.9; 1–68) | 35.4 (32.7; 1–138) | .12 | 20.9 (13.9; 1–70) | 38.2 (34.9; 1–168) | .001 |
Abbreviations: BAL, bronchoalveolar lavage; BAS, bronchoaspirate; BDG, β-D-glucan; CAPA, COVID-19–associated pulmonary aspergillosis; CCI, Charlson Comorbidity Index; CMV, cytomegalovirus; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; CT, computed tomographic; GM, galactomannan; HIV, human immunodeficiency virus; ICU, intensive care unit; IMV, invasive mechanical ventilation; IPA, invasive pulmonary aspergillosis; L-Amb, liposomal amphotericin; LOS, length of hospital stay; PCR, polymerase chain reaction; PIPA, putative IPA; SOFA, Sequential Organ Failure Assessment.
aData represent no. (%) of patients unless otherwise specified.
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