Singh Ashutosh, Kaur Amtoj, Chowdhary Anuradha
Medical Mycology Unit, Department of Microbiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India; National Reference Laboratory for Antimicrobial Resistance in Fungal Pathogens, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
Medical Mycology Unit, Department of Microbiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
Curr Opin Microbiol. 2023 Oct;75:102365. doi: 10.1016/j.mib.2023.102365. Epub 2023 Aug 23.
COVID-19 pandemic highlighted the complications of secondary fungal infections that occurred globally in severe cases of coronavirus disease managed in the intensive care units. Furthermore, varied underlying host factors, such as preexisting immunosuppression, the use of immunomodulatory agents, and invasive procedures predisposing lung tissues to fungal colonization and proliferation, caused increased susceptibility to fungal infections in COVID-19 patient populations. These invasive fungal infections directly impact the overall length of hospitalization and mortality. The most commonly reported fungal infections in patients with COVID-19 include aspergillosis, invasive candidiasis, and mucormycosis. An overall worldwide increase in the prevalence of candidiasis and aspergillosis was observed in COVID-19 patients , whereas outbreaks of mucormycosis were mainly recorded from India. Diagnostic challenges and limited antifungal treatment options make secondary fungal infections among COVID-19 patients more burdensome, which results in improper management and increased mortality.
新冠疫情凸显了在重症监护病房治疗的冠状病毒病严重病例中全球范围内发生的继发性真菌感染的并发症。此外,各种潜在的宿主因素,如既往存在的免疫抑制、免疫调节药物的使用以及使肺组织易发生真菌定植和增殖的侵入性操作,导致新冠患者群体对真菌感染的易感性增加。这些侵袭性真菌感染直接影响住院总时长和死亡率。新冠患者中最常报告的真菌感染包括曲霉病、侵袭性念珠菌病和毛霉病。在新冠患者中观察到念珠菌病和曲霉病在全球范围内的患病率总体上升,而毛霉病疫情主要记录于印度。诊断挑战和有限的抗真菌治疗选择使新冠患者中的继发性真菌感染负担更重,导致管理不当和死亡率增加。