COVID-19-associated pulmonary aspergillosis in a Japanese man: A case report

Imoto, Waki; Himura, Hoshi; Matsuo, Kenji; Kawata, Sae; Kiritoshi, Ayako; Deguchi, Ryo; Miyashita, Masahiro; Kaga, Shinichiro; Noda, Tomohiro; Yamamoto, Katsumi; Yamada, Koichi; Uchida, Kenichiro; Nishimura, Tetsuro; Yamamoto, Hiromasa; Mizobata, Yasumitsu; Kakeya, Hiroshi

doi:10.1016/j.jiac.2021.02.026

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…The characteristics of the 57 eligible studies is presented in Table 1 (case reports, n = 33 and case series, n = 3) & Table 2 (cohort-studies, n = 21). Most of the studies published were from the five continents that included Europe [n = 24, 42.1%] (Denmark [ 23 ], Italy [ 27 , 34 , 35 ], Ireland [ 29 ], France [ 30 , 69 , 75 ], Spain [ 31 , 45 , 71 ], Greece [ 51 ], Austria [ 54 ], Netherlands [ 55 , 57 ], Germany [ 58 , 63 , 67 ], UK [ 62 , 64 , 78 ], Switzerland [ 74 , 77 ]), Asia [n = 18, 31.5%] (Iran [ 24 , 28 , 68 , 76 ], Iraq [ 39 ], Kuwait [ 33 ], Qatar [ 40 , 53 ], Japan [ 41 , 42 ], India [ 18 , 43 , 46 , 48 , 59 ], Indonesia [ 49 ], China [ 60 ], Pakistan [ 65 ]), North America [n = 10, 17.5%] (USA [ 26 , 32 , 36 , 38 , 44 , 50 , ...…”

Section: Resultsmentioning

confidence: 99%

“…Case report and case series: Based on the methodological quality & synthesis guide, twenty-four (72.7%) case reports were having low [ 18 , 23 – 31 , 33 – 35 , 37 , 38 , 40 , 41 , 43 – 45 , 49 , 52 – 54 ] and nine (27.2%) case reports were having medium risk of bias [ 32 , 36 , 39 , 42 , 46 – 48 , 50 , 51 ]. Whereas, all the three cases series were having low risk of bias [ 55 – 57 ] ( S3 Table ).…”

Section: Resultsmentioning

confidence: 99%

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Antifungal therapy in the management of fungal secondary infections in COVID-19 patients: A systematic review and meta-analysis

et al. 2022

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Objectives The prevalence of fungal secondary infections among COVID-19 patients and efficacy of antifungal therapy used in such patients is still unknown. Hence, we conducted this study to find the prevalence of fungal secondary infections among COVID-19 patients and patient outcomes in terms of recovery or all-cause mortality following antifungal therapy (AFT) in such patients. Methods We performed a comprehensive literature search in PubMed®, Scopus®, Web of Sciences™, The Cochrane Library, ClinicalTrial.gov, MedRxiv.org, bioRxiv.org, and Google scholar to identify the literature that used antifungal therapy for the management fungal secondary infections in COVID-19 patients. We included case reports, case series, prospective & retrospective studies, and clinical trials. Mantel Haenszel random-effect model was used for estimating pooled risk ratio for required outcomes. Results A total of 33 case reports, 3 case series, and 21 cohort studies were selected for final data extraction and analysis. The prevalence of fungal secondary infections among COVID-19 patients was 28.2%. Azoles were the most commonly (65.1%) prescribed AFT. Study shows that high survival frequency among patients using AFT, received combination AFT and AFT used for >28 days. The meta-analysis showed, no significant difference in all-cause mortality between patients who received AFT and without AFT (p = 0.17), between types of AFT (p = 0.85) and the duration of AFT (p = 0.67). Conclusion The prevalence of fungal secondary infections among COVID-19 patients was 28.2%. The survival frequency was high among patients who used AFT for fungal secondary infections, received combination AFT and AFT used for >28 days. However, meta-analysis results found that all-cause mortality in COVID-19 patients with fungal secondary infections is not significantly associated with type and duration of AFT, mostly due to presence of confounding factors such as small number of events, delay in diagnosis of fungal secondary infections, presence of other co-infections and multiple comorbidities.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Antifungal therapy in the management of fungal secondary infections in COVID-19 patients: A systematic review and meta-analysis

et al. 2022

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“…The main diagnostic criteria used were AspICU [103] (seven studies) and modified AspICU (eight studies) [104]. The patients were predominantly male (49, 66.2%) and had a median age of 69 years (inter-quartile range (IQR) [57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74]. The reported major co-morbidities were arterial hypertension (37 patients, 50%), diabetes mellitus (26, 35.1%), chronic pulmonary disease (13, 17.5%), cardiovascular disease (9, 12.2%), and obesity (4, 5.4%).…”

Section: Case Reports and Case Seriesmentioning

confidence: 99%

Invasive Fungal Infections Complicating COVID-19: A Narrative Review

Casalini

Giacomelli

Ridolfo

et al. 2021

JoF

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Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients involved in 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is a diagnostic challenge because its non-specific clinical/imaging features and the fact that the proposed clinically diagnostic algorithms do not really apply to COVID-19 patients. Forty-seven observational studies and 41 case reports have described a total of 478 CAPA cases that were mainly diagnosed on the basis of cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia is a widely described secondary infection in critically ill patients undergoing prolonged hospitalisation, and the case reports and observational studies of 401 cases indicate high crude mortality rates of 56.1% and 74.8%, respectively. COVID-19 patients are often characterised by the presence of known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, and broad-spectrum antibiotics. We also describe 3185 cases of mucormycosis (including 1549 cases of rhino-orbital mucormycosis (48.6%)), for which the main risk factor is a history of poorly controlled diabetes mellitus (>76%). Its diagnosis involves a histopathological examination of tissue biopsies, and its treatment requires anti-fungal therapy combined with aggressive surgical resection/debridement, but crude mortality rates are again high: 50.8% in case reports and 16% in observational studies. The presence of other secondary IFIs usually diagnosed in severely immunocompromised patients show that SARS-CoV-2 is capable of stunning the host immune system: 20 cases of Pneumocystis jirovecii pneumonia, 5 cases of cryptococcosis, 4 cases of histoplasmosis, 1 case of coccidioides infection, 1 case of pulmonary infection due to Fusarium spp., and 1 case of pulmonary infection due to Scedosporium.

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“…The ECMM expert guidelines have recommended voriconazole or isavuconazole as recommended first-line therapy for suspected and confirmed COVID-19-associated pulmonary Aspergillosis [ 40 ]. In a kidney transplant patient diagnosed with invasive pulmonary Aspergillosis, the patient showed recovery following treatment with isavuconazole and nebulized pulmonary amphotericin B combination and removal of immunosuppression [ 41 ]. Another case report of Aspergillosis in a post-COVID-19 patient suggested that pulmonary resection may be the last and most effective strategy to manage the disease.…”

Section: Resultsmentioning

confidence: 99%

When to Initiate Antifungal Treatment in COVID-19 Patients with Secondary Fungal Co-infection

Pruthi¹

2022

Curr Clin Micro Rpt

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Purpose of Review Severe-acute respiratory coronavirus 2 (SARS-CoV-2) has been driving the health care delivery system for over 2 years. With time, many issues related to co-infections in COVID-19 patients are constantly surfacing. There have been numerous reports about various fungal co-infections in patients with COVID-19. The extent of severity of fungal pathogens has been recognized as a substantial cause of morbidity and mortality in this population. Awareness, understanding, and a systematic approach to managing fungal co-infections in COVID-19 patients are important. No guidelines have enumerated the stepwise approach to managing the fungal infections co-occurring with COVID-19. This review is intended to present an overview of the fungal co-infections in COVID-19 patients and their stepwise screening and management. Recent Findings The most common fungal infections that have been reported to co-exist with COVID-19 are Candidemia, Aspergillosis, and Mucormycosis. Prevalence of co-infections in COVID-19 patients has been reported to be much higher in hospitalized COVID-19 patients, especially those in intensive care units. While clear pathogenetic mechanisms have not been delineated, COVID-19 patients are at a high risk of invasive fungal infections. Summary As secondary fungal infections have been challenging to treat in COVID-19 patients, as they tend to affect the critically ill or immunocompromised patients, a delay in diagnosis and treatment may be fatal. Antifungal drugs should be initiated with caution after carefully assessing the immune status of the patients, drug interactions, and adverse effects. The crucial factors in successfully treating fungal infections in COVID-19 patients are optimal diagnostic approach, routine screening, and timely initiation of antifungal therapy.

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COVID-19-associated pulmonary aspergillosis in a Japanese man: A case report

Cited by 11 publications

References 22 publications

Antifungal therapy in the management of fungal secondary infections in COVID-19 patients: A systematic review and meta-analysis

Antifungal therapy in the management of fungal secondary infections in COVID-19 patients: A systematic review and meta-analysis

Invasive Fungal Infections Complicating COVID-19: A Narrative Review

When to Initiate Antifungal Treatment in COVID-19 Patients with Secondary Fungal Co-infection

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