State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Nanshan School of Guangzhou Medical University, Guangzhou, China.
Front Public Health. 2022 Sep 7;10:943234. doi: 10.3389/fpubh.2022.943234. eCollection 2022.
More than 405 million people have contracted coronavirus disease 2019 (COVID-19) worldwide, and mycotic infection may be related to COVID-19 development. There are a large number of reports showing that COVID-19 patients with mycotic infection have an increased risk of mortality. However, whether mycotic infection can be considered a risk factor for COVID-19 remains unknown. We searched the PubMed and Web of Science databases for studies published from inception to December 27, 2021. Pooled effect sizes were calculated according to a random-effects model or fixed-effect model, depending on heterogeneity. We also performed subgroup analyses to identify differences in mortality rates between continents and fungal species. A total of 20 articles were included in this study. Compared with the controls, patients with mycotic infection had an odds ratio (OR) of 2.69 [95% confidence interval (CI): 2.22-3.26] for mortality and an OR of 2.28 (95% CI: 1.65-3.16) for renal replacement therapy (RRT). We also conducted two subgroup analyses based on continent and fungal species, and we found that Europe and Asia had the highest ORs, while Candida was the most dangerous strain of fungi. We performed Egger's test and Begg's test to evaluate the publication bias of the included articles, and the -value was 0.423, which indicated no significant bias. Mycotic infection can be regarded as a risk factor for COVID-19, and decision makers should be made aware of this risk.
全球已有超过 4.05 亿人感染了 2019 年冠状病毒病（COVID-19），真菌感染可能与 COVID-19 的发展有关。有大量报道表明，COVID-19 合并真菌感染的患者死亡率增加。然而，真菌感染是否可以被认为是 COVID-19 的危险因素尚不清楚。我们检索了 PubMed 和 Web of Science 数据库，检索时间截至 2021 年 12 月 27 日。根据随机效应模型或固定效应模型计算汇总效应量，具体取决于异质性。我们还进行了亚组分析，以确定不同大陆和真菌物种之间的死亡率差异。本研究共纳入 20 篇文章。与对照组相比，合并真菌感染的患者死亡率的比值比（OR）为 2.69（95%置信区间[CI]：2.22-3.26），需要肾脏替代治疗（RRT）的 OR 为 2.28（95%CI：1.65-3.16）。我们还根据大陆和真菌物种进行了两项亚组分析，发现欧洲和亚洲的 OR 最高，而念珠菌是最危险的真菌菌株。我们进行了 Egger 检验和 Begg 检验来评估纳入文章的发表偏倚，检验值为 0.423，表明没有显著的偏倚。真菌感染可被视为 COVID-19 的危险因素，决策者应意识到这一风险。
