† These authors contributed equally.
Academic Editor: Graham Pawelec
Purpose: The aim of this observational study was to highlight high
resolution CT scan characteristics of COVID-19-associated pulmonary aspergillosis
(CAPA) with a focus on the detection of de-novo appeared or evolved
bronchiectasis. Methods: From March 2020 to May 2021, we enrolled 350
consecutive mechanically ventilated ICU patients with COVID-19. Patients with
CAPA and at least one chest CT scan performed within 15 days from the diagnosis
were included. Two radiologists were asked to identify typical and atypical signs
of COVID-19 pneumonia. Bronchiectasis locations were described and a modified
Reiff score was calculated, as severity score. A total of 19 CAPA patients
(median age 71.0, Interquartile range (IQR) 62.5–75.0; male 16, 84.2%) were included.
Results: According to the 2020 ECMM/ISHAM criteria, 18 patients had
probable CAPA and one had proven CAPA. The median time between hospital admission
and CT scan was 21 days (IQR 14.5–25.0). The incidence of bronchiectasis in the
study population was 57.9% (n = 11). Tubular bronchiectasis was detected in 10
patients and were scored as follows: three patients had a score of 1, three
patients had a score of score 2, one patient had a score of 5 and four patients
had a score of 6. Eight patients had a previous CT scan (performed at hospital
admission), among them: 5 patients developed de-novo bronchiectasis, while 2
patients demonstrated a volumetric increase of bronchiectasis. At the 6-months
follow-up, the mortality rate for patients with CAPA was
