Mucormycosis, one month after recovery from COVID-19: A case report

Alian, Shahriar; Ahangarkani, Fatemeh; Boskabadi, Javad; Kargar-Soleimanabad, Saeed; Delavarian, Leila; Pakzad, Azalia

doi:10.1016/j.amsu.2022.103911

Cited by 5 publications

(14 citation statements)

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“…We assessed full texts of 48 studies, out of which 32 were excluded: 1 narrative review, 4 expert recommendations, 18 editorial materials or viewpoints, 1 non-human study, 2 reports on patients without coinfection, 5 articles on patients without COVID-19, and 1 epidemiological study without data on coinfection ( Supplementary Material S1 ). In total, we included 16 studies reporting 25 cases of coinfection ( Supplementary Material S2 ) [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. The detailed characteristics of the included studies are presented in Supplementary Material S3 .…”

Section: Resultsmentioning

confidence: 99%

“…The included studies were conducted in Spain [ 27 , 31 , 33 , 35 , 38 ], Italy [ 32 ], Belgium [ 40 ], Ireland [ 36 ], the USA [ 29 , 30 ], Iran [ 25 , 26 ], India [ 28 , 39 ], and Peru [ 34 ]; one meeting abstract did not report the country of the authors [ 37 ]. Of the 25 included cases, 4 were from Ecuador [ 30 , 35 , 38 , 40 ], 3 from Bolivia [ 27 , 31 ], 3 from Honduras [ 27 , 31 ], 2 from Iran [ 25 , 26 ], 2 from India [ 28 , 39 ], 2 from Peru [ 31 , 34 ], 1 from Colombia [ 31 ], 1 from Cambodia [ 29 ], 1 from Morocco [ 31 ], 1 from Italy [ 32 ], 1 from Nigeria [ 36 ], and 1 from Nicaragua [ 37 ]. One study with three cases reported that the patients were from Latin America [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eleven patients did not present any manifestations of strongyloidiasis after coinfection with SARS-CoV-2 [ 25 , 31 , 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Alian et al report on the case of a patient diagnosed with mucormycosis one month after COVID-19 [ 25 ]. Upon admission, he received dexamethasone and remdesivir.…”

Section: Resultsmentioning

confidence: 99%

“…The authors consider that the patient did not present any clinical signs of strongyloidiasis, attributing the clinical picture to the fungal infection. However, Strongyloides were reported in the stool analyses, but no information on any antiparasitic treatment was provided [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

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Coinfection with Strongyloides and SARS-CoV-2: A Systematic Review

et al. 2023

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Background: Treatments for COVID-19, including steroids, might exacerbate Strongyloides disease in patients with coinfection. We aimed to systematically review clinical and laboratory features of SARS-CoV-2 and Strongyloides coinfection, investigate possible interventions, assess outcomes, and identify research gaps requiring further attention. Methods: We searched two electronic databases, LitCOVID and WHO, up to August 2022, including SARS-CoV-2 and Strongyloides coinfection studies. We adapted the World Health Organization—Uppsala Monitoring Centre (WHO-UMC) system for standardized case causality assessment to evaluate if using corticosteroids or other immunosuppressive drugs in COVID-19 patients determined acute manifestations of strongyloidiasis. Results: We included 16 studies reporting 25 cases of Strongyloides and SARS-CoV-2 coinfection: 4 with hyperinfection syndrome; 2 with disseminated strongyloidiasis; 3 with cutaneous reactivation of strongyloidiasis; 3 with isolated digestive symptoms; and 2 with solely eosinophilia, without clinical manifestations. Eleven patients were asymptomatic regarding strongyloidiasis. Eosinopenia or normal eosinophil count was reported in 58.3% of patients with Strongyloides reactivation. Steroids were given to 18/21 (85.7%) cases. A total of 4 patients (19.1%) received tocilizumab and/or Anakirna in addition to steroids. Moreover, 2 patients (9.5%) did not receive any COVID-19 treatment. The causal relationship between Strongyloides reactivation and COVID-19 treatments was considered certain (4% of cases), probable (20% of patients), and possible (20% of patients). For 8% of cases, it was considered unlikely that COVID-19 treatment was associated with strongyloidiasis reactivations; the relationship between the Strongyloides infection and administration of COVID-19 treatment was unassessable/unclassifiable in 48% of cases. Of 13 assessable cases, 11 (84.6%) were considered to be causally associated with Strongyloides, ranging from certain to possible. Conclusions: Further research is needed to assess the frequency and risk of Strongyloides reactivation in SARS-CoV-2 infection. Our limited data using causality assessment supports recommendations that clinicians should screen and treat for Strongyloides infection in patients with coinfection who receive immunosuppressive COVID-19 therapies. In addition, the male gender and older age (over 50 years) may be predisposing factors for Strongyloides reactivation. Standardized guidelines should be developed for reporting future research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Eleven patients did not present any manifestations of strongyloidiasis after coinfection with SARS-CoV-2 [ 25 , 31 , 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Alian et al report on the case of a patient diagnosed with mucormycosis one month after COVID-19 [ 25 ]. Upon admission, he received dexamethasone and remdesivir.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Coinfection with Strongyloides and SARS-CoV-2: A Systematic Review

et al. 2023

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Comparative risk assessment of COVID‐19 associated mucormycosis and aspergillosis: A systematic review

Baral

Aziz

Islam

2022

Health Science Reports

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COVID‐19 is not only limited to a defined array but also has expanded with several secondary infections. Two uncommon opportunistic fungal infections, COVID‐19 associated mucormycosis (CAM) and aspergillosis (CAA), have recently been highly acquainted by many worldwide cases. Two immune response deteriorating factors are considered to be responsible for immunosuppression: comorbidities and medication. Due to unlike infection sites and patterns, CAM and CAA‐associated factors deflect a few degrees of proximity, and the present study is for its assessment. The study evaluated 351 CAM cases and 191 CAA cases retrieved from 65 and 53 articles based on inclusion criteria, respectively. Most of the CAM reported from India and CAA were from four South‐European and West‐European neighbor countries. The mean ages of CAM and CAA were 52.72 ± 13.74 and 64.81 ± 11.14, correspondingly. Mortality of CAA (56.28%) was two times greater than CAM (26.02%). Nevertheless, the count of diabetes cases was very high in CAM compared to CAA. The main comorbidities of CAM were diabetes (nearly 80%) and hypertension (more than 38%). All noticeable complications were higher in CAA except diabetes, and these were diabetes (34.55%), hypertension (45.03%), and obesity (18.32%). Moreover, pre‐existing respiratory complications like asthma and chronic obstructive pulmonary disease are visible in CAA. The uses of steroids in CAM and CAA were nearly 70% and 66%, respectively. Almost one‐fourth of CAA cases were reported using immunosuppressant monoclonal antibodies, whereas only 7.69% were for CAM. The overall finding highlights diabetes, hypertension, and steroids as the risk factors for CAM, whereas obesity, chronic pulmonary disease, and immunosuppressants for CAA.

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Amphotericin-B/dexamethasone/prednisolone

2022

Reactions Weekly

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Mucormycosis, one month after recovery from COVID-19: A case report

Cited by 5 publications

References 18 publications

Coinfection with Strongyloides and SARS-CoV-2: A Systematic Review

Coinfection with Strongyloides and SARS-CoV-2: A Systematic Review

Comparative risk assessment of COVID‐19 associated mucormycosis and aspergillosis: A systematic review

Amphotericin-B/dexamethasone/prednisolone

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