Objective:

To compare the demographic, clinical, laboratory characteristics, and outcomes of patients with invasive pulmonary aspergillosis (IPA) following influenza A/B versus COVID-19, specifically focusing on clinical outcomes.

Key Findings:

• CAPA patients had significantly lower lymphocyte counts, particularly CD4+, CD8+, and B cells (p < 0.05).
• Corticosteroid use was more frequent in CAPA patients (p < 0.05).
• The median time from viral diagnosis to IPA detection was longer in CAPA patients (p < 0.05).
• Respiratory bacterial co-infections were more common in the CAPA group (p = 0.030).
• The risk of death within the first 14 days post-IPA diagnosis was 4.92 times higher in CAPA patients (HR = 4.92, 95% CI: 1.35–18.01, p = 0.016).

Interpretation:

The findings indicate that CAPA is associated with more severe immunosuppression and a significantly higher mortality risk shortly after IPA diagnosis compared to IAPA, underscoring the need for timely intervention in clinical practice.

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce bias in data collection.
• Potential confounding factors may not have been fully controlled for.

Conclusion:

CAPA presents a significantly higher early mortality risk compared to IAPA, necessitating prompt therapeutic strategies in affected patients.