Coccidioidomycosis and COVID-19 Co-Infection, United States, 2020

Abstract

We review the interaction between coronavirus disease (COVID-19) and coccidioidomycosis, a respiratory infection caused by inhalation of Coccidioides fungal spores in dust. We examine risk for co-infection among construction and agricultural workers, incarcerated persons, Black and Latino populations, and persons living in high dust areas. We further identify common risk factors for co-infection, including older age, diabetes, immunosuppression, racial or ethnic minority status, and smoking. Because these diseases cause similar symptoms, the COVID-19 pandemic might exacerbate delays in coccidioidomycosis diagnosis, potentially interfering with prompt administration of antifungal therapies. Finally, we examine the clinical implications of co-infection, including severe COVID-19 and reactivation of latent coccidioidomycosis. Physicians should consider coccidioidomycosis as a possible diagnosis when treating patients with respiratory symptoms. Preventive measures such as wearing face masks might mitigate exposure to dust and severe acute respiratory syndrome coronavirus 2, thereby protecting against both infections.

Coronavirus Disease 2019–Associated Invasive Fungal Infection

“…In a third case, a patient with subclinical coccidioidomycosis developed rapid disease dissemination shortly after a mild illness of COVID-19 [ 127 ]. Heaney et al provide a synopsis of possible social, demographic, and exposure risk factor interactions between coccidioidomycosis and COVID-19, focusing on racial and ethnic minorities and the role of geography [ 128 ]. The authors also suggest that chronic lung disease from coccidioidomycosis may increase risk of severe COVID-19 and that COVID-19 may increase the risk of reactivation of latent Coccidioides infection, which has been seen by several authors recently.…”

Diabetes Mellitus and COVID-19: Review Article

“…Patients at risk lived in endemic areas (California, Arizona) and had occupational exposure. Diabetes potentiated the likelihood of disseminated disease, relapsing coccidioidomycosis, and cavitary lung disease [ 70 ]. Fungal infections can be missed, as many of them manifest like COVID-19.…”

Visceral leishmaniasis and COVID-19 coinfection – A case report

“…Re-polarization towards Th1 to face the virus may have led to parasite escape of the immune surveillance, leading to symptomatic VL. There are many cases reporting that COVID-19 has led to re-activation of chronic, asymptomatic infections caused by viruses like VZV, EBV, CMV, HSV, HHV6, HBV [9] , [10] , [11] , protozoa [12] and fungi [13] . On the other hand, VL may have led to a specific polarization of the immune response, that rendered the patient more susceptible to viral infections, including the widely circulating COVID-19, which was transmitted to the patient during the pandemic.…”