Prevalence of opportunistic invasive aspergillosis in COVID-19 patients with severe pneumonia

Mycoses. 2021 Feb;64(2):144-151. doi: 10.1111/myc.13219. Epub 2020 Dec 3.

Abstract

Background: As the global coronavirus pandemic (COVID-19) spreads across the world, new clinical challenges emerge in the hospital landscape. Among these challenges, the increased risk of coinfections is a major threat to the patients. Although still in a low number, due to the short time of the pandemic, studies that identified a significant number of hospitalised patients with COVID-19 who developed secondary fungal infections that led to serious complications and even death have been published.

Objectives: In this scenario, we aim to determine the prevalence of invasive fungal infections (IFIs) and describe possible associated risk factors in patients admitted due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Patients/methods: We designed an open prospective observational study at the Rey Juan Carlos University Hospital (Mostoles, Spain), during the period from February 1 to April 30, 2020.

Results: In this article, we reported seven patients with COVID-19-associated pulmonary aspergillosis (CAPA) who had a poor prognosis. Severely ill patients represent a high-risk group; therefore, we must actively investigate the possibility of aspergillosis in all of these patients. Larger cohort studies are needed to unravel the role of COVID-19 immunosuppressive therapy as a risk factor for aspergillosis.

Conclusions: As the pandemic continues to spread across the world, further reports are needed to assess the frequency of emergent and highly resistant reemergent fungal infections during severe COVID-19. These coinfections are leading a significant number of patients with COVID-19 to death due to complications following the primary viral disease.

Keywords: COVID-19; invasive aspergillosis; lung disease; opportunistic mycosis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aspergillus / genetics
  • Aspergillus / isolation & purification
  • Aspergillus / physiology
  • COVID-19 / complications*
  • COVID-19 / virology
  • Female
  • Hospitalization
  • Humans
  • Intermediate Care Facilities / statistics & numerical data
  • Invasive Pulmonary Aspergillosis / etiology*
  • Invasive Pulmonary Aspergillosis / microbiology
  • Male
  • Middle Aged
  • Opportunistic Infections / etiology
  • Opportunistic Infections / microbiology*
  • Prevalence
  • Prospective Studies
  • SARS-CoV-2 / physiology
  • Spain