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