Aspergillus-SARS-CoV-2 Coinfection: What Is Known?

Abstract

COVID-19-associated pulmonary aspergillosis (CAPA) has had a high incidence. In addition, it has been associated with prolonged hospital stays, as well as several predisposing risk factors, such as fungal factors (nosocomial organism, the size of the conidia, and the ability of the Aspergillus spp. of colonizing the respiratory tract), environmental factors (remodeling in hospitals, use of air conditioning and negative pressure in intensive care units), comorbidities, and immunosuppressive therapies. In addition to these factors, SARS-CoV-2 per se is associated with significant dysfunction of the patient's immune system, involving both innate and acquired immunity, with reduced CD4+ and CD8+ T cell counts and cytokine storm. Therefore, this review aims to identify the factors influencing the fungus so that coinfection with SARS-CoV-2 can occur. In addition, we analyze the predisposing factors in the fungus, host, and the immune response alteration due to the pathogenicity of SARS-CoV-2 that causes the development of CAPA.

COVID-19-associated pulmonary aspergillosis (CAPA): identification of Aspergillus species and determination of antifungal susceptibility profiles

“…Therefore, the focus has been on the development of new algorithms based on symptoms compatible with Aspergillus spp. cultures, host factors, and abnormal imaging to improve the process of obtaining information about the disease agent and prognosis (Marr et al 2021 ; White et al 2021 ; Castro-Fuentes et al 2022 ). Current studies particularly highlight the need to monitor COVID-19 patients who develop ARDS and remain in intensive care for IPA (Chiumello et al 2022 ).…”

Significance of Aspergillus spp. isolation in defining cases of COVID-19 Associated Pulmonary Aspergillosis – CAPA

“… 24 All evaluated patients had known predisposing factors for aspergillosis, including current or past smoking and alcoholism, diabetes mellitus, use of corticosteroids, and/or immunosuppression. 2 Among the five cases of probable CAPA, two had presumed Chronic Obstructive Pulmonary Disease (COPD), one patient was investigating interstitial lung disease, and one patient had COVID-19 and CAPA while presenting with febrile neutropenia after chemotherapy for T-cell lymphoma. Previous bronchopulmonary disease has also been associated with CAPA.…”

“… 1 Severe COVID-19 cases are admitted to Intensive Care Units (ICUs) and undergo invasive procedures and immunosuppressive therapy, which are additional factors for nosocomial infections by various types of microorganisms. 2 , 3 …”

Culturable Airborne Fungi in Downtown Monterrey (Mexico) and Their Correlation with Air Pollution over a 12-Month Period

“…Considering that during 2022, the average concentration of PM2.5 for every month of the year was higher than both the WHO recommendations and Mexican policies with monthly averages ranging from 14.3 to 34.38 µg/m 3 , the population of Monterrey lives with a permanently increased risk of respiratory diseases and with the presence of medically important fungi that can cause respiratory infections. In addition, the risk of fungal infections or even co-infections is feasible, particularly for Aspergillus [33].…”