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. 2022 Mar 3;9(5):ofac081. doi: 10.1093/ofid/ofac081

Figure 1.

Figure 1.

Coronavirus disease 2019-associated pulmonary aspergillosis (CAPA) and invasive pulmonary aspergillosis (IPA). The relationship between CAPA and IPA in critically ill patients with coronavirus disease 2019 (COVID-19) is represented by a Venn diagram. Coronavirus disease 2019-associated pulmonary aspergillosis criteria (large circle on left) signify the likely presence of Aspergillus in the respiratory tract. Invasive pulmonary aspergillosis (small circle on right) is defined by Aspergillus invasion and attendant damage of respiratory tract tissue. Some patients who fulfill CAPA diagnostic criteria have IPA (group 2), but others do not (group 1). In groups 1 and 2, a diagnosis of CAPA can be considered false positive (FP) or true positive (TP) for IPA, respectively. Several critically ill patients with COVID-19 may have IPA without fulfilling criteria for CAPA (group 3, represented by the asterisk in the Venn diagram). In this group, CAPA is false negative (FN) for IPA. It is plausible, but as yet unproven, that IPA in some patients is preceded by CAPA that represents Aspergillus colonization of the respiratory tract.