Invasive Fungal Infections Complicating COVID-19: A Narrative Review

Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Giacomo Casalini, Andrea Giacomelli, Annalisa Ridolfo, Cristina Gervasoni, Spinello Antinori
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 invasive fungal infections aspergillosis CAPA candidemia mucormycosis Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/48b4db53cf5949a1801a21e4fb66c0ae
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:48b4db53cf5949a1801a21e4fb66c0ae
record_format	dspace
spelling	oai:doaj.org-article:48b4db53cf5949a1801a21e4fb66c0ae2021-11-25T18:05:46ZInvasive Fungal Infections Complicating COVID-19: A Narrative Review10.3390/jof71109212309-608Xhttps://doaj.org/article/48b4db53cf5949a1801a21e4fb66c0ae2021-10-01T00:00:00Zhttps://www.mdpi.com/2309-608X/7/11/921https://doaj.org/toc/2309-608XInvasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients involved in 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is a diagnostic challenge because its non-specific clinical/imaging features and the fact that the proposed clinically diagnostic algorithms do not really apply to COVID-19 patients. Forty-seven observational studies and 41 case reports have described a total of 478 CAPA cases that were mainly diagnosed on the basis of cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia is a widely described secondary infection in critically ill patients undergoing prolonged hospitalisation, and the case reports and observational studies of 401 cases indicate high crude mortality rates of 56.1% and 74.8%, respectively. COVID-19 patients are often characterised by the presence of known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, and broad-spectrum antibiotics. We also describe 3185 cases of mucormycosis (including 1549 cases of rhino-orbital mucormycosis (48.6%)), for which the main risk factor is a history of poorly controlled diabetes mellitus (>76%). Its diagnosis involves a histopathological examination of tissue biopsies, and its treatment requires anti-fungal therapy combined with aggressive surgical resection/debridement, but crude mortality rates are again high: 50.8% in case reports and 16% in observational studies. The presence of other secondary IFIs usually diagnosed in severely immunocompromised patients show that SARS-CoV-2 is capable of stunning the host immune system: 20 cases of <i>Pneumocystis jirovecii</i> pneumonia, 5 cases of cryptococcosis, 4 cases of histoplasmosis, 1 case of coccidioides infection, 1 case of pulmonary infection due to <i>Fusarium</i> spp., and 1 case of pulmonary infection due to <i>Scedosporium.</i>Giacomo CasaliniAndrea GiacomelliAnnalisa RidolfoCristina GervasoniSpinello AntinoriMDPI AGarticleCOVID-19invasive fungal infectionsaspergillosisCAPAcandidemiamucormycosisBiology (General)QH301-705.5ENJournal of Fungi, Vol 7, Iss 921, p 921 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 invasive fungal infections aspergillosis CAPA candidemia mucormycosis Biology (General) QH301-705.5
spellingShingle	COVID-19 invasive fungal infections aspergillosis CAPA candidemia mucormycosis Biology (General) QH301-705.5 Giacomo Casalini Andrea Giacomelli Annalisa Ridolfo Cristina Gervasoni Spinello Antinori Invasive Fungal Infections Complicating COVID-19: A Narrative Review
description	Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients involved in 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is a diagnostic challenge because its non-specific clinical/imaging features and the fact that the proposed clinically diagnostic algorithms do not really apply to COVID-19 patients. Forty-seven observational studies and 41 case reports have described a total of 478 CAPA cases that were mainly diagnosed on the basis of cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia is a widely described secondary infection in critically ill patients undergoing prolonged hospitalisation, and the case reports and observational studies of 401 cases indicate high crude mortality rates of 56.1% and 74.8%, respectively. COVID-19 patients are often characterised by the presence of known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, and broad-spectrum antibiotics. We also describe 3185 cases of mucormycosis (including 1549 cases of rhino-orbital mucormycosis (48.6%)), for which the main risk factor is a history of poorly controlled diabetes mellitus (>76%). Its diagnosis involves a histopathological examination of tissue biopsies, and its treatment requires anti-fungal therapy combined with aggressive surgical resection/debridement, but crude mortality rates are again high: 50.8% in case reports and 16% in observational studies. The presence of other secondary IFIs usually diagnosed in severely immunocompromised patients show that SARS-CoV-2 is capable of stunning the host immune system: 20 cases of <i>Pneumocystis jirovecii</i> pneumonia, 5 cases of cryptococcosis, 4 cases of histoplasmosis, 1 case of coccidioides infection, 1 case of pulmonary infection due to <i>Fusarium</i> spp., and 1 case of pulmonary infection due to <i>Scedosporium.</i>
format	article
author	Giacomo Casalini Andrea Giacomelli Annalisa Ridolfo Cristina Gervasoni Spinello Antinori
author_facet	Giacomo Casalini Andrea Giacomelli Annalisa Ridolfo Cristina Gervasoni Spinello Antinori
author_sort	Giacomo Casalini
title	Invasive Fungal Infections Complicating COVID-19: A Narrative Review
title_short	Invasive Fungal Infections Complicating COVID-19: A Narrative Review
title_full	Invasive Fungal Infections Complicating COVID-19: A Narrative Review
title_fullStr	Invasive Fungal Infections Complicating COVID-19: A Narrative Review
title_full_unstemmed	Invasive Fungal Infections Complicating COVID-19: A Narrative Review
title_sort	invasive fungal infections complicating covid-19: a narrative review
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/48b4db53cf5949a1801a21e4fb66c0ae
work_keys_str_mv	AT giacomocasalini invasivefungalinfectionscomplicatingcovid19anarrativereview AT andreagiacomelli invasivefungalinfectionscomplicatingcovid19anarrativereview AT annalisaridolfo invasivefungalinfectionscomplicatingcovid19anarrativereview AT cristinagervasoni invasivefungalinfectionscomplicatingcovid19anarrativereview AT spinelloantinori invasivefungalinfectionscomplicatingcovid19anarrativereview
_version_	1718411614193975296

Invasive Fungal Infections Complicating COVID-19: A Narrative Review

Ejemplares similares