COVID-19 in Patients With Hematologic-Oncologic Risk Factors: Complications in Three Patients

Tafti, Dawood; Kluckman, Matthew; Dearborn, Michael C; Hunninghake, John; Clayton, Sara

doi:10.7759/cureus.12064

Cited by 7 publications

(14 citation statements)

References 19 publications

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“…Nine case reports and seven case series were retrieved [108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123], together reporting 41 cases of candidemia (Table 4; detailed information about the individual studies is given in Table S4). The median time from ICU admission or intubation to the diagnosis of candidemia was 13.5 days (IQR 7.5-29.5), and more than 80% of the patients had an indwelling vascular catheter, received broad-spectrum antibiotics, and underwent mechanical ventilation before its onset.…”

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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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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“…Co-infections by Candida have been observed in both women and men, but predominantly in men over the age of 40 [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. The predisposing factors of candidiasis were multiple, including mechanical ventilation, placement of a central venous catheter, diabetes mellitus, antibiotics treatment, hospitalization time, anti-inflammatory treatment, and cancer [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , …”

Section: Candidiasis and Covid-19mentioning

confidence: 99%

“…Other less common risk factors were asthma, HIV, and surgery, among others [ 34 , 35 , 36 , 38 , 41 , 45 , 47 , 48 , 49 , 50 , 52 , 56 , 60 ]. The diagnosis was performed through culture, PCR, sequencing, and MALDI-TOF [ 33 , 34 , 35 , 36 , 37 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. The most identified pathogen was C. albicans , followed by C. glabrata , C. parapsilosis , C. tropicalis , C. auris , C. krusei , C. lusitaniae , C. inconspicua , C. dubliniensis , C. orthopsilosis , Candida spp.…”

Section: Candidiasis and Covid-19mentioning

confidence: 99%

“…The most identified pathogen was C. albicans , followed by C. glabrata , C. parapsilosis , C. tropicalis , C. auris , C. krusei , C. lusitaniae , C. inconspicua , C. dubliniensis , C. orthopsilosis , Candida spp. and non- albicans Candida [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Patient treatment included azole antifungal agents (fluconazole, voriconazole, isavuconazole), echinocandins (caspofungin, anidulafungin, micafungin), and polyenes (amphotericin B, nystatin) [ 33 , 34 , 35 , 40 , 42 , 43 , 44 , 46 , 47 , 48 , 51 , 52 , 53 , 54 , 56 , 59 ].…”

Section: Candidiasis and Covid-19mentioning

confidence: 99%

“…It should be noted that nystatin was used for the treatment of a patient with oropharyngeal candidiasis [ 43 ]. Despite antifungal treatment, the fatality rate among patients with COVID-19 and candidiasis oscillated between 11 and 100% [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ].…”

Section: Candidiasis and Covid-19mentioning

confidence: 99%

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Epidemiology of Systemic Mycoses in the COVID-19 Pandemic

Frías-De-León

Pinto‐Almazán

Hernández‐Castro

et al. 2021

JoF

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The physiopathologic characteristics of COVID-19 (high levels of inflammatory cytokines and T-cell reduction) promote fungal colonization and infection, which can go unnoticed because the symptoms in both diseases are very similar. The objective of this work was to study the current epidemiology of systemic mycosis in COVID-19 times. A literature search on the subject (January 2020–February 2021) was performed in PubMed, Embase, Cochrane Library, and LILACS without language restrictions. Demographic data, etiological agent, risk factors, diagnostic methods, antifungal treatment, and fatality rate were considered. Eighty nine publications were found on co-infection by COVID-19 and pneumocystosis, candidiasis, aspergillosis, mucormycosis, coccidioidomycosis, or histoplasmosis. In general, the co-infections occurred in males over the age of 40 with immunosuppression caused by various conditions. Several species were identified in candidiasis and aspergillosis co-infections. For diagnosis, diverse methods were used, from microbiological to molecular. Most patients received antifungals; however, the fatality rates were 11–100%. The latter may result because the clinical picture is usually attributed exclusively to SARS-CoV-2, preventing a clinical suspicion for mycosis. Diagnostic tests also have limitations beginning with sampling. Therefore, in the remainder of the pandemic, these diagnostic limitations must be overcome to achieve a better patient prognosis.

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