tetano
Editor, Senior Moderator
J Fungi (Basel)
. 2022 Apr 17;8(4):415.
doi: 10.3390/jof8040415.
Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
Francesca Raffaelli[SUP] 1 [/SUP], Eloisa Sofia Tanzarella[SUP] 2 3 [/SUP], Gennaro De Pascale[SUP] 2 3 [/SUP], Mario Tumbarello[SUP] 4 5 [/SUP]
Affiliations
Abstract
Patients with coronavirus disease 19 (COVID-19) admitted to the intensive care unit (ICU) often develop respiratory fungal infections. The most frequent diseases are the COVID-19 associated pulmonary aspergillosis (CAPA), COVID-19 associated pulmonary mucormycosis (CAPM) and the Pneumocystis jirovecii pneumonia (PCP), the latter mostly found in patients with both COVID-19 and underlying HIV infection. Furthermore, co-infections due to less common mold pathogens have been also described. Respiratory fungal infections in critically ill patients are promoted by multiple risk factors, including epithelial damage caused by COVID-19 infection, mechanical ventilation and immunosuppression, mainly induced by corticosteroids and immunomodulators. In COVID-19 patients, a correct discrimination between fungal colonization and infection is challenging, further hampered by sampling difficulties and by the low reliability of diagnostic approaches, frequently needing an integration of clinical, radiological and microbiological features. Several antifungal drugs are currently available, but the development of new molecules with reduced toxicity, less drug-interactions and potentially active on difficult to treat strains, is highly warranted. Finally, the role of prophylaxis in certain COVID-19 populations is still controversial and must be further investigated.
Keywords: CAM; CAPA; COVID-19; SARS-CoV-2; pneumocystosis; respiratory fungal infection.
. 2022 Apr 17;8(4):415.
doi: 10.3390/jof8040415.
Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
Francesca Raffaelli[SUP] 1 [/SUP], Eloisa Sofia Tanzarella[SUP] 2 3 [/SUP], Gennaro De Pascale[SUP] 2 3 [/SUP], Mario Tumbarello[SUP] 4 5 [/SUP]
Affiliations
- PMID: 35448646
- DOI: 10.3390/jof8040415
Abstract
Patients with coronavirus disease 19 (COVID-19) admitted to the intensive care unit (ICU) often develop respiratory fungal infections. The most frequent diseases are the COVID-19 associated pulmonary aspergillosis (CAPA), COVID-19 associated pulmonary mucormycosis (CAPM) and the Pneumocystis jirovecii pneumonia (PCP), the latter mostly found in patients with both COVID-19 and underlying HIV infection. Furthermore, co-infections due to less common mold pathogens have been also described. Respiratory fungal infections in critically ill patients are promoted by multiple risk factors, including epithelial damage caused by COVID-19 infection, mechanical ventilation and immunosuppression, mainly induced by corticosteroids and immunomodulators. In COVID-19 patients, a correct discrimination between fungal colonization and infection is challenging, further hampered by sampling difficulties and by the low reliability of diagnostic approaches, frequently needing an integration of clinical, radiological and microbiological features. Several antifungal drugs are currently available, but the development of new molecules with reduced toxicity, less drug-interactions and potentially active on difficult to treat strains, is highly warranted. Finally, the role of prophylaxis in certain COVID-19 populations is still controversial and must be further investigated.
Keywords: CAM; CAPA; COVID-19; SARS-CoV-2; pneumocystosis; respiratory fungal infection.