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

Abstract

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.

Case report: Experience and insights on the treatment of two cases of cryptococcal meningitis during the later stages of the COVID-19 pandemic

“…Given potential effects of SARS-CoV-2 on T-cells, more study is needed ( 17 ). On the contrary, studies have shown that there is no observed difference in mortality rates between patients with CM infected with COVID-19 and those without COVID-19 infection ( 18 ). Considering the potential overlap in symptoms between cryptococcal disease and COVID-19, rapid diagnosis of Cryptococcus through blood culture testing is crucial for prompt patient identification.…”