Infecciones fúngicas en pacientes con COVID-19

Messina, Fernando; Marín, Emmanuel; Valerga, Mario; Depardo, Roxana; Chediak, Viviana; Romero, M. Carolina; Benchetrit, Andrés; Lista, Nicolás; Rodríguez, Alejandra; Domínguez, C. Martín; Bouzas, Belén; Cunto, Eleonora; Vaustat, Daniela; Santiso, Gabriela

doi:10.52226/revista.v29i105.49

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…A recent meta-analysis of patients with COVID-19 shows a similar evolution of people living with HIV/AIDS with antiretroviral treatment compared with those living with HIV/AIDS but without antiretroviral therapy 9 . In this study, despite their degree of immunocompromise, the evolution of patients living with HIV/AIDS was not worse than that of HIV-negative patients.…”

Section: Discussionmentioning

confidence: 96%

“…From myalgia, arthralgia, and anosmia to severe bilateral pneumonia 21 . As it occurs in cryptococcosis, fever and headache were the most frequently observed symptoms in patients with HIV/AIDS with COVID-19 9 . For this reason, in the pandemic context, many patients attributed this symptomatology to COVID-19, but could have overlooked a possible fungal infection.…”

Section: Discussionmentioning

confidence: 99%

“…The association between fungal infections and COVID-19 has been the subject of multiple publications, especially for cases of aspergillosis, candidiasis, and mucormycosis (7)(8)(9). However, although the association between COVID-19 and cryptococcosis was reported in HIV-negative patients treated with immunomodulators (10) and in patients with autoimmune diseases (11), the number of cryptococcosis infections in people living with HIV/AIDS was low and, in general, they were excluded of the most recent reviews (12).…”

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confidence: 99%

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Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS

Messina,

Benchetrit,

Bocassi

et al. 2023

biomedica

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Introduction. Fungal infections in patients with COVID-19 was one of the most debated topics during the pandemic.Objectives. To analyze the clinical characteristics and evolution of people living with HIV/AIDS and coinfection with cryptococcus and COVID-19 (group A) or without it (group B).Materials and methods. This is an analytical and retrospective study. We reviewed medical records of patients with meningeal cryptococcosis between April 2020 and May 2021.Results. We studied 65 people living with HIV/AIDS and with cryptococcosis infection diagnosed from April 2020 to May 2021. Fifteen patients with HIV/AIDS suffered from cryptococcosis and COVID-19, and out of these, 14 presented meningitis (group A), while 28 suffered from meningeal cryptococcosis, but did not have COVID-19 (group B).Conclusions. No statistically significant differences were observed between the two groups (A and B) considering: intracranial hypertension, presence of Cryptococcus antigens in cerebrospinal fluid, sensorium deterioration or mortality.The detection of Cryptococcus antigens in serum by lateral flow assay was highly effective to rapidly diagnose cryptococcosis in patients with HIV/AIDS who also developed COVID-19. Patients of both groups consulted for cryptoccocosis sometime after, in comparison with the pre-pandemic cases related to this infection.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS

Messina,

Benchetrit,

Bocassi

et al. 2023

biomedica

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“…It has been widely demonstrated that therapy with fluconazole as the only drug in cases of meningitis is associated with high mortality [ 32 ]. For this reason, when lumbar puncture is not possible, serum CrAg titers can help to decide between the use of two drugs in induction or monotherapy [ 32 , 34 ], because patients with serum titers higher than 1/160 by LFA or 1/100 by LA have a higher probability of meningitis [ 34 , 35 ]. Consequently, mortality is higher in those patients [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Preemptive Therapy in Cryptococcosis Adjusted for Outcomes

Messina

Santiso

Arechavala

et al. 2023

JoF

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Cryptococcosis is one of the most serious opportunistic diseases in patients living with HIV. For this reason, early diagnosis and appropriate treatment are important. Objectives. The aim of the study was to understand the development of patients diagnosed with cryptococcosis by detection of Cryptococcus antigen in serum by lateral flow assay (CrAg LFA) without nervous system involvement and with treatment in accordance with the results. Materials and Methods. A retrospective, longitudinal, analytical study was performed. Seventy patients with cryptococcosis initially diagnosed by serum CrAg LFA without meningeal involvement between January 2019 and April 2022 were analyzed for medical records. The treatment regimen was adapted to the results of blood culture, respiratory material, and pulmonary tomography imaging. Results. Seventy patients were included, 13 had probable pulmonary cryptococcosis, 4 had proven pulmonary cryptococcosis, 3 had fungemia, and 50 had preemptive therapy without microbiological or imaging findings compatible with cryptococcosis. Among the 50 patients with preemptive therapy, none had meningeal involvement or cryptococcosis recurrences to date. Conclusion. Preemptive therapy avoided progression to meningitis in CrAg LFA-positive patients. Preemptive therapy with dose adjustment of fluconazole in patients with the mentioned characteristics was useful despite the use of lower doses than recommended.

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“…Fluconazole 100 mg was the most commonly used antifungal agent, which is likely due to the incidence of fungal coinfections. In this sense, Messina et al (2021) mention the frequency and impact of coinfections that affect patients infected with SARS-CoV-2 due to fungi such as Candida spp., invasive aspergillosis, endemic systemic mycoses, and pneumocystosis.…”

Section: Discussionmentioning

confidence: 99%

Drug utilization in patients with SARS-CoV-2 in an intensive care unit

Méndez¹,

López²,

Barragán³

et al. 2022

J Pharm Pharmacogn Res

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Context: Prescription indication studies allow identifying the problems that arise during the use of the drug. Aims: To evaluate the treatments used in patients diagnosed with SARS-CoV-2 infection hospitalized in critical care service, through a prescription indication study. Methods: A longitudinal observational study of medication use of the indication-prescription type with elements of the therapeutic scheme and practical consequences was carried out. The sample was characterized from the sociodemographic, clinical, and pharmacotherapeutic points of view. The prescription was evaluated through the indicators: indication, therapeutic scheme, treatment individualization, and drug combinations. The detected adverse reactions were classified according to their causality by the Naranjo Algorithm, their severity, their clinical significance, and according to their mechanism by Rawlins and Thompson. Results: In the sample (n = 77), the male gender predominated (79%) between 27-59 years old (64%), alcohol consumer (62%), hypertensive (33%) with long hospital stay (51%). A total of 417 medications were analyzed, being antibiotics (50.6%) the most prescribed. 73.4% of the therapeutic schemes were correct; however, 26.6% had problems with the therapeutic schemes due to incorrect doses, intervals, duration of treatment, and risky interactions. According to Rawlins and Thompson, two probable adverse reactions were detected, mild, non-serious, and type A and B. Conclusions: The results obtained will allow the pharmaceutical professional to create risk matrices that guarantee a timely intervention in the health team to contribute to the rational and safe use of medicines in patients infected with SARS-CoV-2.

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Infecciones fúngicas en pacientes con COVID-19

Cited by 7 publications

References 22 publications

Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS

Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS

Preemptive Therapy in Cryptococcosis Adjusted for Outcomes

Drug utilization in patients with SARS-CoV-2 in an intensive care unit

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