Table 1  Clinical characteristics of COVID-19 patients with pulmonary aspergillosis published before 10 June 2020.
Country (Prevalence) COHORT [Ref]  Age/Sex  Underlying Conditions  CAPA Classification  Local/Systemic Corticosteroid Use  GM (ODI)/Serum BDG (pg/mL)/qPCR  Species (Voriconazole Susceptibility Pattern)  Treatment #  Outcome
Germany (5/19; 26.3%)ARDS [50]  62/F  Cholecystectomy for cholecystitis, arterial hypertension, obesity with sleep apnea, hypercholesterolemia, ex-smoker, COPD (GOLD 2)  Putative  Inhaled steroids for COPD  GM Serum negative GM BALF> 2.5 qPCR BALF = Positive  Aspergillus fumigatus (S) culture from BALF  VCZ  Died
70/M  Vertebral disc prolapse left L4/5, flavectomy and nucleotomy, Ex-smoker  Putative  No  GM Serum = 0.7 GM BALF> 2.5 qPCR BALF = Positive  A. fumigatus by PCR; negative culture  ISA  Died
54/M  Arterial hypertension, diabetes mellitus, aneurysm coiling right A. vertebralis  Putative  Intravenous corticosteroid therapy 0.4 mg/kg/d, total of 13 days)  GM Serum negative GM BALF> 2.5 qPCR BALF = Positive  A. fumigatus (S) culture from tracheal aspirate  CASPO→ VCZ  Alive
73/M  Arterial hypertension, bullous emphysema, smoker, COPD (GOLD 3), Previous Hepatitis B  Putative  Inhaled steroids for COPD  GM Serum negative qPCR tracheal secretion = Positive  A. fumigatus (S) culture from tracheal aspirate  VCZ  Died
54/F  None  Putative  No  GM Serum = 1.3 and 2.7 qPCR tracheal secretion = Negative  Negative culture  CASPO→ VCZ  Alive
France (9/27; 33.3%)ARDS * [51]  53/M  Hypertension, obesity, ischemic heart disease  Putative  Dexamethasone iv 20 mg once daily from day 1 to day 5, followed by 10 mg once daily from day 6 to day 10  GM Serum = 0.13 GM BALF = 0.89 BDG = 523 qPCR = Negative  Negative culture  None  Alive
59/F  Hypertension, obesity, diabetes  Putative  No  GM Serum = 0.04 GM BALF = 0.03 qPCR = Negative  A. fumigatus, culture from BALF  None  Alive
69/F  Hypertension, obesity  Putative  Dexamethasone iv 20 mg once daily from day 1 to day 5, followed by 10 mg once daily from day 6 to day 10  GM Serum = 0.04 BDG = 7.8 qPCR BALF = 23.9  A. fumigatus, culture from tracheal secretion  None  Alive
63/F  Hypertension, diabetes, ischemic heart disease  Putative  Dexamethasone iv 20 mg once daily from day 1 to day 5, followed by 10 mg once daily from day 6 to day 10  GM Serum = 0.51GM BALF = 0.15 BDG = 63  Negative culture  None  Died
43/M  Asthma with steroid use history  Putative  No  GM Serum = 0.04 GM BALF = 0.12 BDG = 7 qPCR = Negative  A. fumigatus, culture from BALF  None  Alive
79/M  Hypertension  Putative  Dexamethasone iv 20 mg once daily from day 1 to day 5, followed by 10 mg once daily from day 6 to day 10  GM Serum = 0.02 GM BALF = 0.05 BDG = 23 qPCR BALF = 34.5  A. fumigatus, culture from BALF  None  Alive
77/M  Hypertension, asthma  Putative  Dexamethasone iv 20 mg once daily from day 1 to day 5, followed by 10 mg once daily from day 6 to day 10  GM Serum = 0.37 GM BALF = 3.91 BDG = 135 qPCR BALF = 29  A. fumigatus, culture from BALF  VCZ  Died
75/F  Hypertension, diabetes  Putative  Dexamethasone iv 20 mg once daily from day 1 to day 5, followed by 10 mg once daily from day 6 to day 10  GM Serum = 0.37 GM BALF = 0.36 BDG = 450 qPCR BALF = 31.7  A. fumigatus, culture from BALF  CASPO  Died
47/M  Multiple myeloma with steroid therapy  Probable  No  GM Serum = 0.09 BDG = 14  A. fumigatus, culture from tracheal secretion  None  Died
Netherlands (6/31; 19.4%)ARDS [47]  83/M  Cardiomyopathy  Possible  Prednisolone 0ꞏ13mg/kg/day for 28 dayspre-admission  GM Serum = 0.4  A. fumigatus, culture from tracheal aspirate  VCZ + ANID (5/6) L-AmB (1/6)  Died
67/M  COPD (GOLD 3), Post RTx NSCLC 2014  Possible  Prednisolone 0ꞏ37mg/kg/day for 2 dayspre-admission  NA  A. fumigatus, culture from tracheal aspirate  Died
75/M  COPD (GOLD 2a)  Probable  No  GM BALF = 4.0  A. fumigatus, culture from BALF  Died
43/M  None  Probable  No  GM Serum = 0.1 GM BALF = 3.8  NA  Alive
57/M  Bronchial asthma  Probable  Fluticasone 1ꞏ94 mcg/kg/day for 1 month pre-admission  GM Serum = 0.1 GM BALF = 1.6  A. fumigatus. culture from BALF  Died
58/M  None  Possible  No  NA  Aspergillus spp. (S), culture from sputum  Alive
Belgium (7/20; 35%)ARDS [52]  86/M  Hypercholesterinemia  NA  No  GM serum = 0.1  A. flavus culture from tracheal aspirate  None  Died
38/M  Obesity, hypercholesterinemia  Proven  No  GM serum = 0.3 GM BALF > 2.8  A. fumigatus culture from BALF  VCZ, ISA  Alive
62/M  Diabetes  Proven  No  GM serum = 0.2 GM BALF = 2  A. fumigatus culture from BALF  VCZ  Died
73/M  Diabetes, obesity, hypertension, hypercholesterinemia  Proven  No  GM serum= 0.1 GM BALF > 2.8  A. fumigatus culture from BALF  VCZ  Alive
77/M  Diabetes, chronic kidney disease, hypertension, pemphigus foliaceus  Proven  Yes, ND  GM serum = 0.1 GM BALF = 2.79  A. fumigatus culture from BALF  VCZ  Alive
55/M  HIV, hypertension, hypercholesterinemia  NA  No  GM serum = 0.80 GM BALF = 0.69  Negative culture  VCZ, ISA  Died
75/M  Acute myeloid leukemia  NA  No  GM BALF = 2.63  A. fumigatus culture from BALF  VCZ  Died
France (1)ARDS [57]  74/M  Myelodysplastic syndrome, CD8 + T-cell lymphocytosis, Hashimoto’s thyroiditis, hypertension, benign prostatic hypertrophy  Putative  No  First GM on tracheal secretion = Negative First qPCR = Positive Second GM tracheal secretion = NA Second qPCR = Positive Direct smear of the second sample = branched septate hyphae  A. fumigatus, culture of the second tracheal secretion  None  Died
France (1/5; 20%)Mixed ICU [58]  80/M  Thyroid cancer (patient presented with ARDS)  Putative  NA  No  A. flavus, culture from tracheal secretion  VCZ→ ISA  Died
Italy (1)ARDS [59]  73/M  Diabetes, hypertension, obesity, hyperthyroidism, atrial fibrillation  Proven  No  GM Serum = 8.6 qPCR from paraffin block tissue = Positive  A. fumigatus, culture from BALF  L-AmB → ISA  Died
Austria (1)ARDS [60]  70/M  COPD (GOLD 2), obstructive sleep apnea syndrome, insulin-dependent type 2 diabetes with end organ damage, arterial hypertension, coronary heart disease, and obesity  Putative  Inhaled Budesonide (400 mg per day)  GM Serum = Negative BDG = Negative LFD Positive from endotracheal aspiration  A. fumigatus, culture from endotracheal aspiration  VCZ  Died
Germany (2)ARDS [61]  80/M  Suspected pulmonary fibrosis  ND  No  GM Serum = 1.5 GM BALF = 6.3  A. fumigatus, culture from BALF  L-AmB  Died
70/M  None  ND  No  GM Serum = Negative GM BALF = 6.1  A. fumigatus, culture from BALF  L-AmB  Died
Netherlands (1)ARDS [62]  74/F  Polyarthritis, reflux, stopped smoking 20 years ago  Putative  No  GM serum = Persistently < 0.5 GM tracheal aspirate = >3 BDG serum = 1590  A. fumigatus, culture from tracheal aspirate (R)TR34/L98HICZ = 16µg/mL, VCZ = 2µg/mL, and POSA = 0.5µg/ml  VCZ + CASPO→ Oral VCZ→ L-AmB  Died
Australia (1) ARDS [63]  66/F  Hypertension, osteopenia, ex-smoker (20 pack years)  Putative  No  N/A  A. fumigatus culture from tracheal aspirate (3x)  VCZ + Therapeutic Drug monitoring  Alive
* All serum qPCR remained negative. # All dosages are standard dosages (e.g., VCZ 6 mg/kg bid Day 1, and 4 mg/kg bid starting Day 2) [64]. ARDS: acute respiratory distress syndrome; NA: not applicable; ND: not determined; BALF: bronchoalveolar lavage fluid; BDG: beta-D-Glucan; COPD: chronic obstructive pulmonary disease; GM; galactomannan; GOLD: global initiative for chronic obstructive lung disease; NSCLC: non-small-cell lung cancer; ODI: optical density index; RTx: radio therapy; LFD: lateral flow device; qPCR: quantitative real-time PCR; VCZ: voriconazole; ISA: isavuconazole; CASPO: caspofungin; ANID: anidulafungin; L-AmB: liposomal amphotericin B; ICZ: itraconazole; POSA = posaconazole.