COVID-19 Associated Pulmonary Aspergillosis (CAPA) and Other Invasive Fungal Infections (IFI)
COVID-19 Associated Pulmonary Aspergillosis (CAPA) and Other Invasive Fungal Infections (IFI)
The purpose of this study is to identify the number of individuals with severe CoVID who
 require ventilator support and who develop serious fungal infections. The study is an
 observational study, meaning that we are not providing any intervention that does not involve
 usual standard of care. Our chief goal is to find evidence of fungal infection by using
 traditional, approved methods of diagnosis, but by applying these methods in the same way and
 frequency among all study participants. We will be looking especially for evidence of a
 fungal infection known as Aspergillus, which can causes a serious lung infection called
 invasive aspergillosis (IA).
COVID-19 is a disease caused by infection with the novel coronavirus SARS-COV2 which emerged
 in late 2019 in Wuhan, China (1). This illness is associated with viral prodromal symptoms,
 then subsequently fever, cough, and shortness of breath (1). In a subset of patients, lower
 respiratory tract infection associated with respiratory failure develops. Among these
 patients, progression to severe respiratory failure and ARDS requiring ventilator support has
 occurred in an alarming number of patients at rates that are many-fold higher than what is
 typically associated with seasonal influenza A or B (2). One of the most feared complications
 of post-influenza respiratory failure is the development of invasive pulmonary aspergillosis
 which may occur in as many as 15-20% of those requiring ventilator support (based on European
 data) (3-6). Among those developing IA following influenza A or B, mortality of 50% or
 greater is reported (3-6).
Inclusion Criteria:

 -  Adults aged 18 years or older at the time of enrollment

 -  SARS-COV2 positivity by PCR with respiratory failure requiring mechanical ventilation
 for at least 72 hours

 -  Prior therapy with antifungals, including prophylaxis, is NOT an exclusion.

 Exclusion Criteria:

 -  Life expectancy of less than 72 hours as determined by the site investigator.

 -  Expected to be weaned from mechanical ventilation in next 24 hours

 -  Care received in any setting other than an intensive care unit (ICU) at the time of
 enrollment