Respiratory failure & ventilation
Longitudinal mycological profiling of influenza-associated and COVID-19-associated pulmonary aspergillosis
Authors' conclusion
In this large virus-associated pulmonary aspergillosis cohort, BAL GM kinetics emerged as a potential prognostic biomarker. Early and sustained increases in BAL GM values identify patients at increased risk of mortality.
Study context
- Population
- Adults with probable/proven IAPA or CAPA requiring mechanical ventilation, tertiary care ICU in Belgium, 2009–2024698 bronchoalveolar lavage (BAL) samples
- Participants
- 180 adults
- Exposure
- Longitudinal BAL galactomannan dynamics and mortality
- IAPAn = 68
- CAPAn = 112
- Outcome
- Association of longitudinal BAL GM trends with time-to-death
- Follow-up
- 30 and 90 days
Methodological detailssingle-centre, tertiary care ICU, Bayesian joint models, linear mixed-effects models
- Single-centre
- Tertiary care ICU
- Bayesian joint models
- Linear mixed-effects models
Main finding
As reported in the abstract
Hazard of death per unit increase in GM over time
Adjusted hazard ratio
1.19
P = 0.02
30 days after ICU admission
Adjusted hazard ratio
1.19
P = 0.007
90 days after ICU admission
Observational data: associations, not effects.
Further findings
BAL galactomannan (GM) decline after aspergillosis diagnosis
- BAL GM declined significantly over days after diagnosis, steeper in survivors
- Interaction p < 0.05
Persistent BAL culture positivity
- Correlated with worse outcomes
Original publication
Longitudinal mycological profiling of influenza-associated and COVID-19-associated pulmonary aspergillosis. Crit Care. Published 9 January 2026. doi:10.
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