COVID-19-associated fungal infections

Hoenigl, Martin; Seidel, Danila; Sprute, Rosanne; Cunha, Cristina; Oliverio, Matteo; Goldman, Gustavo H.; Ibrahim, Ashraf S.; Carvalho, Agostinho

doi:10.1038/s41564-022-01172-2

Cited by 289 publications

(238 citation statements)

References 167 publications

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“…Both bacteria, including Streptococcus pneumoniae , Staphylococcus aureus , Klebsiella pneumoniae , Mycoplasma pneumoniae , Chlamydia pneumonia , Legionella pneumophila , and viruses including influenza, coronavirus, rhinovirus/enterovirus, parainfluenza, metapneumovirus, and human immunodeficiency virus (HIV) have been reported as co-pathogens. However, the COVID-19-associated fungal infections caused by Candida , Aspergillus , and Mucor ales cannot be neglected [ 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Recently, several cases of COVID-19 with Cryptococcus co- or secondary infection as opportunistic infections have been reported [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], However, many issues about the epidemiology, pathogenesis, clinical and microbiological manifestations, and treatment of COVID-19-associated cryptococcosis remained unclear due to limited studies.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

Chan

Lai

et al. 2022

JoF

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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a great threat to global health. In addition to SARS-CoV-2 itself, clinicians should be alert to the possible occurrence of co-infection or secondary infection among patients with COVID-19. The possible co-pathogens include bacteria, viruses, and fungi, but COVID-19-associated cryptococcosis is rarely reported. This review provided updated and comprehensive information about this rare clinical entity of COVID-19-associated cryptococcosis. Through an updated literature search till 23 August 2022, we identified a total of 18 culture-confirmed case reports with detailed information. Half (n = 9) of them were elderly. Fifteen (83.3%) of them had severe COVID-19 and ever received systemic corticosteroid. Disseminated infection with cryptococcemia was the most common type of cryptococcosis, followed by pulmonary and meningitis. Except one case of C. laurentii, all other cases are by C. neoformans. Liposomal amphotericin B and fluconazole were the most commonly used antifungal agents. The overall mortality was 61.1% (11/18) and four of them did not receive antifungal agents before death. Improving the poor outcome requires a physician’s high suspicion, early diagnosis, and prompt treatment.

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Section: Introductionmentioning

confidence: 99%

COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

Chan

Lai

et al. 2022

JoF

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“…Every year approximately 3 million people acquire systemic fungal infections, of which approximately half die ( Brown et al, 2012 ). The majority of life-threatening fungal infections are caused by species belonging to one of four genera: Cryptococcus , Candida , Aspergillus and Pneumocystis although infections caused by members of the order Mucorales are also frequently reported ( Bongomin et al, 2017 , Brown et al, 2012 ) and are often associated with various co-morbidities ( Raut, 2021 , Hoenigl et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

The nature of the fungal cargo induces significantly different temporal programmes of macrophage phagocytosis

et al. 2022

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“…Since 2019, SARS-CoV-2 belongs to one of the most prevalent viral pathogens worldwide. It is well documented that COVID-19 patients often suffer from various infectious diseases, which also include fungal infections (88)(89)(90)(91). This is due to the weakened immune system of the patients, as well as the treatment used to cure COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Genome-wide scan for potential CD4+ T-cell vaccine candidates in Candida auris by exploiting reverse vaccinology and evolutionary information

et al. 2022

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Candida auris is a globally emerging fungal pathogen responsible for causing nosocomial outbreaks in healthcare associated settings. It is known to cause infection in all age groups and exhibits multi-drug resistance with high potential for horizontal transmission. Because of this reason combined with limited therapeutic choices available, C. auris infection has been acknowledged as a potential risk for causing a future pandemic, and thus seeking a promising strategy for its treatment is imperative. Here, we combined evolutionary information with reverse vaccinology approach to identify novel epitopes for vaccine design that could elicit CD4+ T-cell responses against C. auris. To this end, we extensively scanned the family of proteins encoded by C. auris genome. In addition, a pathogen may acquire substitutions in epitopes over a period of time which could cause its escape from the immune response thus rendering the vaccine ineffective. To lower this possibility in our design, we eliminated all rapidly evolving genes of C. auris with positive selection. We further employed highly conserved regions of multiple C. auris strains and identified two immunogenic and antigenic T-cell epitopes that could generate the most effective immune response against C. auris. The antigenicity scores of our predicted vaccine candidates were calculated as 0.85 and 1.88 where 0.5 is the threshold for prediction of fungal antigenic sequences. Based on our results, we conclude that our vaccine candidates have the potential to be successfully employed for the treatment of C. auris infection. However, in vivo experiments are imperative to further demonstrate the efficacy of our design.

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COVID-19-associated fungal infections

Cited by 289 publications

References 167 publications

COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

The nature of the fungal cargo induces significantly different temporal programmes of macrophage phagocytosis

Genome-wide scan for potential CD4+ T-cell vaccine candidates in Candida auris by exploiting reverse vaccinology and evolutionary information

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