<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience

Objective: to describe a single-center experience of <i>Pneumocystis jirovecii</i> pneumonia (PJP) in non-HIV patients recovering from COVID-19. Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital. Results: With the exceptio...

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Autores principales:	Ivan Gentile, Giulio Viceconte, Amedeo Lanzardo, Irene Zotta, Emanuela Zappulo, Biagio Pinchera, Riccardo Scotto, Nicola Schiano Moriello, Maria Foggia, Agnese Giaccone, Gaetana Messina, Paola Salvatore, Antonio Riccardo Buonomo, Federico II COVID-19 Team
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 <i>Pneumocystis jirovecii</i> invasive fungal infections corticosteroids lymphopenia Medicine R
Acceso en línea:	https://doaj.org/article/e514a5201a11473995b76f1adc1eb2d8
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spelling	oai:doaj.org-article:e514a5201a11473995b76f1adc1eb2d82021-11-11T16:30:52Z<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience10.3390/ijerph1821113991660-46011661-7827https://doaj.org/article/e514a5201a11473995b76f1adc1eb2d82021-10-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11399https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Objective: to describe a single-center experience of <i>Pneumocystis jirovecii</i> pneumonia (PJP) in non-HIV patients recovering from COVID-19. Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital. Results: With the exception of one subject, who experienced an atypical and prolonged course of COVID-19, all the patients developed PJP after the clinical resolution of COVID-19 pneumonia. All but one patient had no pre-existing immunosuppressive conditions or other risk factors for PJP development at COVID-19 diagnosis. Nonetheless, following the course of COVID-19 infection, all the patients fulfilled at least one host factor for PJP; indeed, all the patients had received at least 2 weeks of high-dose steroids and three out of five had a CD4+ cell count <200/mm<sup>3</sup>. Conclusions: The use of corticosteroids for COVID-19 respiratory impairment seems to be the most common risk factor for PJP, together with viral-induced and iatrogenic lymphopenia. The worsening in respiratory function and the characteristic radiological picture during or after COVID-19 pneumonia should raise the suspicion of PJP, even in immunocompetent patients. PJP primary chemoprophylaxis can be considered in selected high-risk COVID-19 patients, but further studies are needed.Ivan GentileGiulio ViceconteAmedeo LanzardoIrene ZottaEmanuela ZappuloBiagio PincheraRiccardo ScottoNicola Schiano MorielloMaria FoggiaAgnese GiacconeGaetana MessinaPaola SalvatoreAntonio Riccardo BuonomoFederico II COVID-19 TeamMDPI AGarticleCOVID-19<i>Pneumocystis jirovecii</i>invasive fungal infectionscorticosteroidslymphopeniaMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11399, p 11399 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 <i>Pneumocystis jirovecii</i> invasive fungal infections corticosteroids lymphopenia Medicine R
spellingShingle	COVID-19 <i>Pneumocystis jirovecii</i> invasive fungal infections corticosteroids lymphopenia Medicine R Ivan Gentile Giulio Viceconte Amedeo Lanzardo Irene Zotta Emanuela Zappulo Biagio Pinchera Riccardo Scotto Nicola Schiano Moriello Maria Foggia Agnese Giaccone Gaetana Messina Paola Salvatore Antonio Riccardo Buonomo Federico II COVID-19 Team <i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience
description	Objective: to describe a single-center experience of <i>Pneumocystis jirovecii</i> pneumonia (PJP) in non-HIV patients recovering from COVID-19. Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital. Results: With the exception of one subject, who experienced an atypical and prolonged course of COVID-19, all the patients developed PJP after the clinical resolution of COVID-19 pneumonia. All but one patient had no pre-existing immunosuppressive conditions or other risk factors for PJP development at COVID-19 diagnosis. Nonetheless, following the course of COVID-19 infection, all the patients fulfilled at least one host factor for PJP; indeed, all the patients had received at least 2 weeks of high-dose steroids and three out of five had a CD4+ cell count <200/mm<sup>3</sup>. Conclusions: The use of corticosteroids for COVID-19 respiratory impairment seems to be the most common risk factor for PJP, together with viral-induced and iatrogenic lymphopenia. The worsening in respiratory function and the characteristic radiological picture during or after COVID-19 pneumonia should raise the suspicion of PJP, even in immunocompetent patients. PJP primary chemoprophylaxis can be considered in selected high-risk COVID-19 patients, but further studies are needed.
format	article
author	Ivan Gentile Giulio Viceconte Amedeo Lanzardo Irene Zotta Emanuela Zappulo Biagio Pinchera Riccardo Scotto Nicola Schiano Moriello Maria Foggia Agnese Giaccone Gaetana Messina Paola Salvatore Antonio Riccardo Buonomo Federico II COVID-19 Team
author_facet	Ivan Gentile Giulio Viceconte Amedeo Lanzardo Irene Zotta Emanuela Zappulo Biagio Pinchera Riccardo Scotto Nicola Schiano Moriello Maria Foggia Agnese Giaccone Gaetana Messina Paola Salvatore Antonio Riccardo Buonomo Federico II COVID-19 Team
author_sort	Ivan Gentile
title	<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience
title_short	<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience
title_full	<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience
title_fullStr	<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience
title_full_unstemmed	<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience
title_sort	<i>pneumocystis jirovecii</i> pneumonia in non-hiv patients recovering from covid-19: a single-center experience
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e514a5201a11473995b76f1adc1eb2d8
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<i>Pneumocystis jirovecii</i> Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience

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