Kundu Reetu, Singla Nidhi
Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Microbiology, Government Medical College Hospital, Chandigarh, India.
Curr Fungal Infect Rep. 2022;16(2):47-54. doi: 10.1007/s12281-022-00432-2. Epub 2022 Apr 9.
Severe-acute respiratory coronavirus 2 (SARS-CoV-2) causing corona virus disease 2019 (COVID-19) has been the single most important pathogen driving health care delivery system for the last one and half years. Now, as the time is passing, many issues related to co-infections/secondary infections/superinfections in COVID-19 patients are emerging. The literature is getting enriched everyday by addition of reports from all over the world for the same. The purpose of this review is to decipher the plethora of fungal infections in COVID-19.
COVID-19 infection along with it brought many risk factors namely lung injury, immunosuppression, need for oxygen therapy, monoclonal antibodies, steroid therapy, etc. which are known predisposing factors for fungal infections. Rather the extent and severity of fungal pathogens has been so much that it has led to new terminologies like CAC (COVID-19-associated ), CAPA (COVID-19-associated pulmonary aspergillosis) and CAM (COVID-19-associated mucormycosis). There is increase in invasiveness of , prevalence of aspergillosis in COVID-19 damaged lung and outbreak of mucormycosis in COVID-19 patients resulting in "double trouble," keeping laboratory personnel, clinicians, and intensivists on their toes in managing these patients.
Awareness and understanding regarding these possible complications is necessary to decrease the morbidity and mortality among patients. The COVID-19 and fungal coinfections may bring more insight into ways of pathogenesis of fungal infections, need for better antifungal agents, quick diagnostic modalities, and better management policies in the near future.
导致2019冠状病毒病(COVID-19)的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在过去一年半中一直是推动医疗保健系统运转的最重要单一病原体。如今,随着时间推移,COVID-19患者中与合并感染/继发感染/重叠感染相关的诸多问题正在浮现。世界各地关于此类问题的报告不断增加,使得相关文献日益丰富。本综述的目的是解读COVID-19中大量的真菌感染情况。
COVID-19感染带来了许多危险因素,如肺损伤、免疫抑制、氧疗需求、单克隆抗体、类固醇治疗等,这些都是已知的真菌感染易感因素。事实上,真菌病原体的范围和严重程度已达到了导致出现新术语的程度,如CAC(COVID-19相关的)、CAPA(COVID-19相关的肺曲霉病)和CAM(COVID-19相关的毛霉病)。COVID-19损伤肺中曲霉病的侵袭性增加、患病率上升,以及COVID-19患者中毛霉病的暴发造成了“双重麻烦”,使得实验室人员、临床医生和重症监护医生在管理这些患者时需时刻保持警惕。
了解和认识这些可能的并发症对于降低患者的发病率和死亡率至关重要。COVID-19与真菌合并感染可能会为真菌感染的发病机制、对更好抗真菌药物的需求、快速诊断方法以及未来更好的管理策略带来更多见解。