Hlaing Kyaw M, Monday Lea M, Nucci Marcio, Nouér Simone A, Revankar Sanjay G
Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI 48201, USA.
University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil.
J Fungi (Basel). 2023 Jun 14;9(6):667. doi: 10.3390/jof9060667.
The COVID-19 pandemic caused >6 million deaths worldwide, often from respiratory failure. Complications frequently occurred in hospitalized patients, particularly in the intensive care unit. Among these, fungal infections were a cause of high morbidity and mortality. Invasive aspergillosis, candidiasis and mucormycosis were the most serious of these infections. Risk factors included alterations in immune defense mechanisms by COVID-19 itself, as well as immunosuppression due to various therapies utilized in severely ill patients. Diagnosis was often challenging due to lack of sensitivity of current testing. Outcomes were generally poor, due to significant co-morbidities and delayed diagnosis, with mortality rates >50% in some studies. High index of clinical suspicion is needed to facilitate early diagnosis and initiation of appropriate antifungal therapy.
新冠疫情在全球造成了超过600万人死亡，死因通常是呼吸衰竭。并发症在住院患者中经常出现，尤其是在重症监护病房。其中，真菌感染是导致高发病率和高死亡率的一个原因。侵袭性曲霉病、念珠菌病和毛霉病是这些感染中最严重的。风险因素包括新冠病毒本身导致的免疫防御机制改变，以及重症患者使用的各种疗法引起的免疫抑制。由于目前检测方法缺乏敏感性，诊断往往具有挑战性。由于存在严重的合并症和诊断延迟，总体预后通常较差，一些研究中的死亡率超过50%。需要高度的临床怀疑指数来促进早期诊断并启动适当的抗真菌治疗。
