Frías-De-León María Guadalupe, Pinto-Almazán Rodolfo, Hernández-Castro Rigoberto, García-Salazar Eduardo, Meza-Meneses Patricia, Rodríguez-Cerdeira Carmen, Arenas Roberto, Conde-Cuevas Esther, Acosta-Altamirano Gustavo, Martínez-Herrera Erick
Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ciudad de México PC 56530, Estado de México, Mexico.
Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Col. Casco de Santo Tomas, Alcaldía Miguel Hidalgo, Ciudad de México PC 11340, Estado de México, Mexico.
J Fungi (Basel). 2021 Jul 13;7(7):556. doi: 10.3390/jof7070556.
The physiopathologic characteristics of COVID-19 (high levels of inflammatory cytokines and T-cell reduction) promote fungal colonization and infection, which can go unnoticed because the symptoms in both diseases are very similar. The objective of this work was to study the current epidemiology of systemic mycosis in COVID-19 times. A literature search on the subject (January 2020-February 2021) was performed in PubMed, Embase, Cochrane Library, and LILACS without language restrictions. Demographic data, etiological agent, risk factors, diagnostic methods, antifungal treatment, and fatality rate were considered. Eighty nine publications were found on co-infection by COVID-19 and pneumocystosis, candidiasis, aspergillosis, mucormycosis, coccidioidomycosis, or histoplasmosis. In general, the co-infections occurred in males over the age of 40 with immunosuppression caused by various conditions. Several species were identified in candidiasis and aspergillosis co-infections. For diagnosis, diverse methods were used, from microbiological to molecular. Most patients received antifungals; however, the fatality rates were 11-100%. The latter may result because the clinical picture is usually attributed exclusively to SARS-CoV-2, preventing a clinical suspicion for mycosis. Diagnostic tests also have limitations beginning with sampling. Therefore, in the remainder of the pandemic, these diagnostic limitations must be overcome to achieve a better patient prognosis.
新型冠状病毒肺炎（COVID-19）的生理病理特征（炎症细胞因子水平高和T细胞减少）会促进真菌定植和感染，而这可能未被察觉，因为两种疾病的症状非常相似。这项工作的目的是研究COVID-19时期系统性真菌病的当前流行病学情况。在PubMed、Embase、Cochrane图书馆和LILACS上对该主题进行了文献检索（2020年1月至2021年2月），无语言限制。考虑了人口统计学数据、病原体、危险因素、诊断方法、抗真菌治疗和死亡率。发现了89篇关于COVID-19与肺孢子菌病、念珠菌病、曲霉病、毛霉病、球孢子菌病或组织胞浆菌病合并感染的出版物。一般来说，合并感染发生在40岁以上因各种情况导致免疫抑制的男性中。在念珠菌病和曲霉病合并感染中鉴定出了几种菌种。对于诊断，使用了从微生物学到分子学的多种方法。大多数患者接受了抗真菌药物治疗；然而，死亡率为11%-100%。后者可能是因为临床表现通常仅归因于严重急性呼吸综合征冠状病毒2（SARS-CoV-2），从而无法对真菌病产生临床怀疑。诊断测试从采样开始就存在局限性。因此，在大流行的剩余时间里，必须克服这些诊断局限性以实现更好的患者预后。
