Invasive pulmonary aspergillosis (IPA) is a severe infection caused by aspergillus sp. that usually develops in patients with severe immunosuppression. IPA has been recently described in critically ill COVID-19 patients (termed as COVID-associated pulmonary aspergillosis, or CAPA) that are otherwise immunocompetent. In order to describe the characteristics of patients with CAPA, we conducted a retrospective cohort study in a tertiary care center in Mexico City. We included all patients with confirmed COVID-19 admitted to the intensive care unit that had serum or bronchoalveolar lavage galactomannan measurements. We used the criteria proposed by Koehler et al. to establish the diagnosis of CAPA. Main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital mortality. Out of a total of 83 hospitalized patients with COVID-19 in the ICU, 16 (19.3%) met the criteria for CAPA. All patients diagnosed with CAPA required IMV whereas only 84% of the patients in the non-IPA group needed this intervention (P = 0.09). In the IPA group, 31% (n = 5) of the patients died, compared to 13% (n = 9) in the non-CAPA group (P = 0.08). We conclude that CAPA is a frequent co-infection in critically ill COVID-19 patients and is associated with a high mortality rate. The timely diagnosis and treatment of IPA in these patients is likely to improve their outcome. Lay Summary We studied the characteristics of patients with COVID-19-associated invasive pulmonary aspergillosis (CAPA). Patients with CAPA tended to need invasive mechanical ventilation more frequently and to have a higher mortality rate. Adequate resources for its management can improve their outcome

RESUMENEn los últimos años, se ha puesto especial atención a los microorganismos que habitan el cuerpo humano; solía creerse que estos eran simples huéspedes. Sin embargo, se ha enfocado la atención en estudiar la relación entre estos microorganismos y la salud de los seres humanos. En este artículo de revisión, pretendemos exponer la relación entre la microbiota y ciertas enfermedades gastrointestinales, metabólicas, cardiovasculares, neuropsiquiátricas y alérgicas, de acuerdo con la evidencia actual. Realizamos una revisión en PubMed, con los términos MeSH «microbioma», «microbiota», «gastrointestinal disease», «metabolic disease», «Neuropsychiatry» y «allergy». Incluimos artículos en inglés y español, publicados entre 2000 y 2021, que fueran metaanálisis, artículos de revisión, ensayos clínicos y experimentales de mayor relevancia, para cumplir el objetivo de este manuscrito. El microbioma es esencial para mantener el estado de salud de un ser humano. Alteraciones en el microbioma pueden provocar diversas enfermedades, desde las relacionadas con el tracto gastrointestinal hasta neuropsiquiátricas.