Post-Viral Aspergillosis

Abstract

Post-viral aspergillosis (PVA) is a clinical form of Aspergillus infection that occurs after some viral infections. Aspergillus is the most common respiratory fungal co-pathogen in patients with viral infections. Most cases of PVA have been reported as invasive pulmonary aspergillosis (IPA) after influenza, COVID-19, and the cytomegalovirus infection. PVA is more commonly reported in critically ill patients with viral pneumonia. Suggested risk factors for PVA include cellular immune deficiency, ARDS, pulmonary tracts and parenchyma damage, and corticosteroid therapy. New pulmonary nodules such as dense, well-circumscribed lesions with or without a halo sign, air crescent sign, or cavity, or wedge-shaped and segmental or lobar consolidation on the chest CT scan can suggest PVA. As in the treatment of invasive aspergillosis in other settings, triazoles, such as voriconazole or isavuconazole, have been suggested as the first-line treatment for PVA. It seems that the presence of PVA has significantly decreased the survival rate in patients with viral infections.