Prevalence of Aspergillus and extremely resistant bacterial superinfection among sever Covid-19 patients

Background and objectives: Co-infections involving bacteria or viruses alongside severe acute respiratory syndrome coronavirus-2 have been documented in numerous studies. The understanding of Aspergillus coinfection in individuals suffering from coronavirus disease 2019 was found to be constrained. This study aims to explore the updated information about coronavirus 2019 associated with pulmonary aspergillosis. Methods: This study was conducted at coronavirus disease-19 hospital and intensive care unit of Sulaimani and San private clinic and laboratories, from jan-2021 to feb-2022. Seventy-five patients were enrolled, including patients who were intubated on a mechanical ventilator and continuous positive airway pressure mask treatment. The intubated patients were screened after 2-3 days. Non-intubated patients on continuous positive airway pressure mask; sputum study was performed if evidence of secondary chest infection was present including rising fever, and productive cough, with laboratory markers and radiologic investigation. Results: Out of 75 patients, 10.7% (n=8) were culture negative, 89.3% (n=67) were secondary microbial infection, 64.0% (n=48) were bacterial infection, 25.3% (n=19) were Aspergillus Species, having invasive pulmonary mold superinfection. The majority (42.1%, n=8) noticed in those aged between 60-70 years. Aspergillus flavus was the dominant mold (52.6%, n=10). 63.2% (n=12) of the Aspergillus infection was recorded in those patients who were treated with steroids for 11-20 days, with significant difference (P<0.001). Conclusion: Increasing age, comorbidity like diabetes and extended course of corticosteroid were linked to a higher incidence of invasive pulmonary aspergillosis. Extremely resistant Acinetobacter and E. coli superinfection were estimated as the most common bacterial element in sever coronavirus-2019 pneumonias.