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We read with great interest the multicenter, observational, retrospective study, which investigated the impact of dexamethasone on the superinfection in 157 mechanically ventilated patients with COVID-19. 1 Compared with the patients without superinfection, those with superinfection had more often received corticosteroid (66%[44/67] versus 32%[28/88], p< 0.0001). Among them, eight patients had invasive fungal infections, including five pulmonary aspergillosis, and all of them had received dexamethasone. 1 Additionally, Borman et al. 2 further demonstrated that COVID-associated pulmonary aspergillosis (CAPA) could be associated with a longer length of hospital stay and higher mortality than the matched critically ill patients without fungal infection. These findings 1, 2 raised the serious concern about whether systemic corticosteroid could increase the risk of aspergillosis. Therefore, we conducted this …