Abstract
Patients with severe COVID-19, such as individuals in intensive care units (ICU), are exceptionally susceptible to bacterial and fungal infections. The most prevalent fungal infections are aspergillosis and candidemia. Nonetheless, other fungal species (for instance, Histoplasma spp., Rhizopus spp., Mucor spp., Cryptococcus spp.) have recently been increasingly linked to opportunistic fungal diseases in COVID-19 patients. These fungal co-infections are described with rising incidence, severe illness, and death that is associated with host immune response. Awareness of the high risks of the occurrence of fungal co-infections is crucial to downgrade any arrear in diagnosis and treatment to support the prevention of severe illness and death directly related to these infections. This review analyses the fungal infections, treatments, outcome, and immune response, considering the possible role of the microbiome in these patients. The search was performed in Medline (PubMed), using the words “fungal infections COVID-19”, between 2020–2021.
Highlights
The present review aims to analyze the prevalence of fungal infections, immune response, and the role of the microbiome in COVID-19 patients
Some reports even state that COVID-19 increases the mortality rate in the patients having fungal infections, but the case reports suggest that individuals with COVID-19 are more susceptible to a fungal infection mostly because of impaired immune responses, which further increases the awareness of clinicians for more effective diagnosis and treatment [28,29]
Based on the available literature, it is suggested to keep a low threshold to investigate for COVID-19 associated pulmonary aspergillosis (CAPA), since an early detection and respective treatment may significantly improve outcomes
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The alteration in human microbiota (due to SARS-CoV-2 infection), which can indicate the progression of COVID-19, may contribute to bacterial, fungal, or viral infections and affect the immune system [1]. In these patients, this is normally described as an increase in pro-inflammatory markers, such as IL-1, IL-6, and tumor necrosis alpha (TNF-α), less CD4 interferon-gamma expression, and a decreased number of CD4 and CD8 cells, which increase susceptibility to bacterial and fungal infections [12]. The present review aims to analyze the prevalence of fungal infections, immune response, and the role of the microbiome in COVID-19 patients
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