Opportunistic Fungal Invasion in COVID-19 Pandemic: A Critical Review in Diagnosis and Management

Abstract

Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) is the culprit behind the pandemic across the globe in recent decades. Variants of SARS-CoV especially coronavirus disease 2019 (COVID-19)-related fungus might not be identified or might be misdiagnosed on a worldwide scale. Patients of COVID-19 acquired invasive mycoses, especially if they are very ill or immunosuppressed. Clinical intervention based on various standard guidelines would be necessary to guarantee that Aspergillus and Candida-infected COVID-19 patients are adequately treated. To facilitate clinical professionals, doctors, paramedics, and laboratory staff in the treatment of various variants of COVID-19 patients with concurrent aspergillosis, candidiasis, mucormycosis, or cryptococcosis, a tabulation format is drafted in this study. We believe it is prudent to take into account the general nature, and variety of the mycosis that is arriving, the strength and limits of the diagnostic tools, clinical conditions, and the need for standardized or customized therapy in various coronavirus-infected patients.

Keywords

SARS-CoV-2 - opportunistic fungal infection - mucormycosis - candidiasis - aspergillosis

Publikationsverlauf

Artikel online veröffentlicht:
03. Juli 2023

• References

• 1 Guan WJ, Ni ZY, Hu Y. et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382 (18) 1708-1720
• 2 Song G, Liang G, Liu W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia 2020; 185 (04) 599-606
• 3 Revannavar SM, P S S, Samaga L. v K V. COVID-19 triggering mucormycosis in a susceptible patient: a new phenomenon in the developing world?. BMJ Case Rep 2021; 14 (04) e241663
• 4 Farmakiotis D, Kontoyiannis DP. Mucormycoses. Infect Dis Clin North Am 2016; 30 (01) 143-163
• 5 Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiology and diagnosis of mucormycosis: an update. J Fungi (Basel) 2020; 6 (04) 265
• 6 Monte Junior ESD, Santos MELD, Ribeiro IB. et al. Rare and fatal gastrointestinal mucormycosis (Zygomycosis) in a COVID-19 patient: a case report. Clin Endosc 2020; 53 (06) 746-749
• 7 Kulkarni R, Misra UK, Meshram C. et al. Epidemic of mucormycosis in COVID-19 pandemic: a position paper. Ann Indian Acad Neurol 2022; 25 (01) 7-10
• 8 Safder S, Carpenter JS, Roberts TD, Bailey N. The “Black Turbinate” sign: an early MR imaging finding of nasal mucormycosis. AJNR Am J Neuroradiol 2010; 31 (04) 771-774
• 9 Millon L, Scherer E, Rocchi S, Bellanger AP. Molecular strategies to diagnose mucormycosis. J Fungi (Basel) 2019; 5 (01) 24
• 10 Cagnoni PJ. Liposomal amphotericin B versus conventional amphotericin B in the empirical treatment of persistently febrile neutropenic patients. J Antimicrob Chemother 2002; 49 (Suppl. 01) 81-86
• 11 Kintzel PE, Smith GH. Practical guidelines for preparing and administering amphotericin B. Am J Hosp Pharm 1992; 49 (05) 1156-1164
• 12 Cornely OA, Alastruey-Izquierdo A, Arenz D. et al; Mucormycosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis 2019; 19 (12) e405-e421
• 13 Marty FM, Ostrosky-Zeichner L, Cornely OA. et al; VITAL and FungiScope Mucormycosis Investigators. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. Lancet Infect Dis 2016; 16 (07) 828-837
• 14 Unnikrishnan R, Anjana RM, Mohan V. Diabetes mellitus and its complications in India. Nat Rev Endocrinol 2016; 12 (06) 357-370
• 15 Kontoyiannis DP, Lewis RE. How I treat mucormycosis. Blood 2011; 118 (05) 1216-1224
• 16 Pappas PG, Lionakis MS, Cavling Arendrup Maiken, Ostrosky-Zeichner L, Jan Kullberg B. Invasive candidiasis; a review article. Jundishapur J Microbiol 2018; 11 (04) 18026
• 17 Arastehfar A, Carvalho A, Nguyen MH. et al. COVID-19-Associated candidiasis (CAC):an underestimated complication in the absence of immunological predisposition?. J Fungi (Basel) 2020; 6 (04) 211
• 18 Morse SS. Factors and determinants of disease emergence. Rev Sci Tech 2004; 23 (02) 443-451
• 19 Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults: a narrative review. Eur J Intern Med 2016; 34: 21-28
• 20 Clancy CJ, Nguyen MH. Finding the "missing 50%" of invasive candidiasis: how nonculture diagnostics will improve understanding of disease spectrum and transform patient care. Clin Infect Dis 2013; 56 (09) 1284-1292
• 21 Ellepola AN, Morrison CJ. Laboratory diagnosis of invasive candidiasis. J Microbiol 2005; 43 (Spec No): 65-84
• 22 Pfaller MA, Moet GJ, Messer SA, Jones RN, Castanheira M. Candida bloodstream infections: comparison of species distributions and antifungal resistance patterns in community-onset and nosocomial isolates in the SENTRY Antimicrobial Surveillance Program, 2008-2009. Antimicrob Agents Chemother 2011; 55 (02) 561-566
• 23 Koehler P, Arendrup MC, Arikan-Akdagli S. et al. European Confederation of Medical Mycology (ECMM). ECMM CandiReg-A ready-to-use platform for outbreaks and epidemiological studies. Mycoses 2019; 62 (10) 920-927
• 24 Ben-Ami R. Treatment of invasive candidiasis: a narrative review. J Fungi (Basel) 2018; 4 (03) 97
• 25 Nguyen MH, Yu VL. Meningitis caused by Candida species: an emerging problem in neurosurgical patients. Clin Infect Dis 1995; 21 (02) 323-327
• 26 Clancy CJ, Nguyen MH. Diagnosing invasive candidiasis. J Clin Microbiol 2018; 56 (05) e01909-e01917
• 27 Lyons JL, Zhang SX. Current laboratory approaches to diagnosis of CNS fungal infections. Future Microbiol 2016; 11 (02) 175-177
• 28 White PL, Dhillon R, Cordey A. et al. A national strategy to diagnose COVID-19 associated invasive fungal disease in the ICU. Clin Infect Dis 2021; 73 (07) e1634-e1644
• 29 Miceli MH, Churay T, Braun T, Kauffman CA, Couriel DR. Risk factors and outcomes of invasive fungal infections in allogeneic hematopoietic cell transplant recipients. Mycopathologia 2017; 182 (5-6): 495-504
• 30 Fishman JA, Grossi PA. Novel Coronavirus-19 (COVID-19) in the immunocompromised transplant recipient: #Flatteningthecurve. Am J Transplant 2020; 20 (07) 1765-1767
• 31 Poli P, Timpano S, Goffredo M, Padoan R, Badolato R. Asymptomatic case of Covid-19 in an infant with cystic fibrosis. J Cyst Fibros 2020; 19 (03) e18
• 32 Koehler P, Cornely OA, Böttiger BW. et al. COVID-19 associated pulmonary aspergillosis. Mycoses 2020; 63 (06) 528-534
• 33 Jamieson AM, Yu S, Annicelli CH, Medzhitov R. Influenza virus-induced glucocorticoids compromise innate host defense against a secondary bacterial infection. Cell Host Microbe 2010; 7 (02) 103-114
• 34 Blot SI, Taccone FS, Van den Abeele AM. et al; AspICU Study Investigators. A clinical algorithm to diagnose invasive pulmonary aspergillosis in critically ill patients. Am J Respir Crit Care Med 2012; 186 (01) 56-64
• 35 Patterson TF, Thompson III GR, Denning DW. et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 2016; 63 (04) e1-e60
• 36 Hage CA, Carmona EM, Epelbaum O. et al. Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med 2019; 200 (05) 535-550
• 37 Perfect. Microbiology and epidemiology of Cryptococcus neoformans infection. [May;2020]. GMCoxJ... R. 2020
• 38 Passerini M, Terzi R, Piscaglia M, Passerini S, Piconi S. Disseminated cryptococcosis in a patient with metastatic prostate cancer who died in the coronavirus disease 2019 (COVID-19) outbreak. Cureus 2020; 12 (05) e8254
• 39 Khatib MY, Ahmed AA, Shaat SB, Mohamed AS, Nashwan AJ. Cryptococcemia in a patient with COVID-19: a case report. Clin Case Rep 2020; 9 (02) 853-855
• 40 Setianingrum F, Rautemaa-Richardson R, Denning DW. Pulmonary cryptococcosis: a review of pathobiology and clinical aspects. Med Mycol 2019; 57 (02) 133-150
• 41 Ibáñez-Martínez E, Ruiz-Gaitán A, Pemán-García J. Update on the diagnosis of invasive fungal infection. Rev Esp Quimioter 2017; 30 (Suppl. 01) 16-21