We found a high incidence of CAPA among critically ill COVID-19 patients and that its occurrence seems to change the natural history of disease.

A total of 108 patients were enrolled.

Prospective, multicentre study on adult patients with microbiologically confirmed COVID-19 receiving mechanical ventilation.

Probable CAPA was diagnosed in 30 (27.7%) of patients after a median of 4 (2-8) days from intensive care unit (ICU) admission.

Kaplan-Meier curves showed a significant higher 30-day mortality rate from ICU admission among patients with either CAPA (44% vs 19%, p= 0.002) or PIPA (74% vs 26%, p<0.001) when compared with patients not fulfilling criteria for aspergillosis.

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