Abstract
Coronavirus disease 2019 (COVID-19), which is caused by novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged at Wuhan in China in December 2019 and has rapidly spread throughout the world. The droplets expelled during face-to-face exposure, mainly through talking, coughing, or sneezing, are the most common mode of transmission. So far, children have not been affected frequently without deaths. However, the course of this virus in the future is unknown. The diagnosis is mainly made through reverse transcription-polymerase chain reaction (RT-PCR) and serology testing. Treatment with dexamethasone at an early phase of developed acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2 alters the pulmonary and systemic inflammatory response and decreases mortality. Corticosteroid therapy is associated with a sizable reduction in the duration of mechanical ventilation and hospital mortality. One of the major risk factor associated with corticosteroid therapy is associated with acquiring secondary infections. Pulmonary epithelial damage and inflammatory disease are the predisposing risk factors for pulmonary aspergillosis due to the release of danger molecular patterns during severe COVID-19. Galactomannan and culture testing of bronchoalveolar lavage fluid are the most sensitive diagnostic measures for aspergillosis in intensive care unit (ICU). Finally, the treatment of coronavirus associated pulmonary aspergillosis is complex. The only way one can prevent the spread of infection by following precautions such as frequent hand washing, wearing a mask in public places, social distancing, and by avoiding unnecessary gatherings.
Highlights
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus which is named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
There are no standard therapeutic regimens to handle the spread of SARS-CoV-2
As dexamethasone is on the list of essential medicines of the World Health Organization (WHO), it is important to accentuate the need for future analyses of the evidence for corticosteroid use in COVID-19, such as its long-term effects and their use in non-severe patients, as they remain unclear and may be studied further
Summary
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus which is named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. Hospitalized patients with clinical and/or radiological suspicion of COVID-19 (history of fever and any respiratory symptom, for example, cough or dyspnea and/or ground-glass opacity or pulmonary consolidation on CT scan), aged 18 years or older at the time of inclusion, with SpO2 ≤94% at room air or in use of supplementary oxygen or under invasive mechanical ventilation. Decline in immune cells, especially T-lymphocytes (lymphocytopenia) and defective immune responses to SARS-CoV-2, has been shown to permit unregulated viral replication, resulting in hyper-inflammation, and serious complications such as ARDS [94], in addition to creating favorable conditions for the acquisition of secondary infections such as CAPA. A recent published study mentioned that SARS-CoV-2 reinfection resulted in worse disease than the first infection in two patients, requiring oxygen support and hospitalization. The study from the Korea Centers for Disease Control and Prevention found that patients with COVID-19 who had a positive repeat RNA test after they had previously been cleared of isolation were unable to isolate the infectious virus in any of 108 patients examined [118]
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