Fig. 1

Cohort derivation plot and main findings of this retrospective observational study of the twice weekly prophylactic use of inhaled liposomal amphotericin-B in mechanically ventilated patients with COVID-19 pneumonia. Whenever feasible in view of patient or clinician safety, the patients were screened for CAPA/AT by assessing platelia galactomannan enzyme immunoassay on bronchoscopy-obtained bronchoalveolar lavage fluid. An index of 1 or more in combination with the presence of pulmonary infiltrates on chest radiography or in combination with ulcers, pseudomembranes or airway plaques encountered during bronchoscopy was considered probable CAPA/AT [2]. During the first pandemic wave, before the routine implementation of high-dose thromboprophylaxis, bronchial biopsy was also regularly performed to demonstrate proven IPA [3]. IPA = invasive pulmonary aspergillosis; CAPA/AT = COVID-19-associated pulmonary aspergillosis/Aspergillus tracheobronchitis; RR = risk ratio