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

IF 3.1 Q2 MICROBIOLOGY Current Clinical Microbiology Reports Pub Date : 2022-01-01 DOI:10.1007/s40588-022-00184-0
Harnoor Singh Pruthi
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引用次数: 2

Abstract

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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继发真菌合并感染的COVID-19患者何时开始抗真菌治疗。
回顾目的:严重急性呼吸道冠状病毒2 (SARS-CoV-2)已经影响了卫生保健服务系统2年多。随着时间的推移,与COVID-19患者合并感染相关的许多问题不断浮出水面。关于COVID-19患者中各种真菌合并感染的报道很多。真菌病原体的严重程度已被认为是这一人群发病率和死亡率的重要原因。认识、理解和系统的方法来管理COVID-19患者的真菌合并感染非常重要。目前还没有指南列举了管理与COVID-19同时发生的真菌感染的分步方法。本文综述了COVID-19患者的真菌合并感染及其逐步筛查和处理。最近的发现:据报道,与COVID-19共存的最常见真菌感染是念珠菌病、曲霉病和毛霉病。据报道,在住院的COVID-19患者中,特别是在重症监护病房的患者中,COVID-19患者中合并感染的发生率要高得多。虽然尚未明确的发病机制,但COVID-19患者的侵袭性真菌感染风险很高。摘要:由于继发性真菌感染在COVID-19患者中一直具有挑战性,因为它们往往影响危重患者或免疫功能低下患者,因此诊断和治疗的延误可能是致命的。在仔细评估患者的免疫状态、药物相互作用和不良反应后,应谨慎开始使用抗真菌药物。优化诊断方法、常规筛查和及时启动抗真菌治疗是成功治疗COVID-19患者真菌感染的关键因素。
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来源期刊
CiteScore
7.50
自引率
1.90%
发文量
9
期刊介绍: Current Clinical Microbiology Reports commissions expert reviews from leading scientists at the forefront of research in microbiology. The journal covers this broad field by dividing it into four key main areas of study: virology, bacteriology, parasitology, and mycology. Within each of the four sections, experts from around the world address important aspects of clinical microbiology such as immunology, diagnostics, therapeutics, antibiotics and antibiotic resistance, and vaccines. Some of the world’s foremost authorities in the field of microbiology serve as section editors and editorial board members. Section editors select topics for which leading researchers are invited to contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, which are highlighted in annotated reference lists. These timely reviews of the literature examine the latest scientific discoveries and controversies as they emerge and are indispensable to both researchers and clinicians. The editorial board, composed of more than 20 internationally diverse members, reviews the annual table of contents, ensures that topics address all aspects of emerging research, and where applicable suggests topics of critical importance to various countries/regions.
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