Giuseppe Pipitone, Daria Spicola, Michelle Abbott, Adriana Sanfilippo, Francesco Onorato, Francesco Di Lorenzo, Antonio Ficalora, Calogero Buscemi, Ilenia Alongi, Claudia Imburgia, Giacomo Ciusa, Stefano Agrenzano, Andrea Gizzi, Federica Guida Marascia, Guido Granata, Francesco CimÒ, Maria Stella Verde, Francesca Di Bernardo, Antonino Scafidi, Vincenzo Mazzarese, Caterina Sagnelli, Nicola Petrosillo, Antonio Cascio, Chiara Iaria
{"title":"Invasive cryptococcal disease in COVID-19: systematic review of the literature and analysis.","authors":"Giuseppe Pipitone, Daria Spicola, Michelle Abbott, Adriana Sanfilippo, Francesco Onorato, Francesco Di Lorenzo, Antonio Ficalora, Calogero Buscemi, Ilenia Alongi, Claudia Imburgia, Giacomo Ciusa, Stefano Agrenzano, Andrea Gizzi, Federica Guida Marascia, Guido Granata, Francesco CimÒ, Maria Stella Verde, Francesca Di Bernardo, Antonino Scafidi, Vincenzo Mazzarese, Caterina Sagnelli, Nicola Petrosillo, Antonio Cascio, Chiara Iaria","doi":"10.53854/liim-3101-2","DOIUrl":null,"url":null,"abstract":"<p><p>During the Coronavirus Disease 2019 (COVID-19) pandemic, an increasing number of fungal infections associated with SARS-CoV-2 infection have been reported. Among them, cryptococcosis could be a life-threatening disease. We performed a Systematic Review (PRISMA Statement) of cryptococcosis and COVID-19 co-infection, case report/series were included: a total of 34 cases were found, then we added our case report. We collected patients' data and performed a statistical analysis comparing two groups of patients sorted by outcome: \"dead\" and \"alive\". Three cases were excluded for lack of information. To compare categorical data, we used a Fisher-exact test (α=0.05). To compare quantitative variables a U Mann-Whitney test was used (α=0.05), with a 95% Confidence Interval. A total of 32 co-infected patients were included in the statistical analysis. Mortality rate was 17/32 (53.1%): these patients were included in \"dead\" group, and 15/32 (46.9%) patients survived and were included in \"alive\" group. Overall, males were 25/32 (78.1%), the median age was 60 years (IQR 53-70) with non-statistically significant difference between groups (p=0.149 and p=0.911, respectively). Three variables were associated with mortality: ARDS, ICU admission and inadequate treatment. Overall, 21 out of 24 (87.5%) patients were in ARDS with a statistically significant difference among two groups (p=0.028). ICU admission for COVID-19 was observed in 18/26 (69.2%), more frequently among dead group (p=0.034). Finally, 15/32 (46.9%) patients had adequate treatment (amphotericin B + flucytosine for invasive cryptococcosis) mostly among alive patients (p=0.039). In conclusion, mortality due to cryptococcal infection among COVID-19 patients remains high but an early diagnosis and appropriate treatment could reduce mortality.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994830/pdf/1124-9390_31_1_2023_006-012.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infezioni in Medicina","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.53854/liim-3101-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
During the Coronavirus Disease 2019 (COVID-19) pandemic, an increasing number of fungal infections associated with SARS-CoV-2 infection have been reported. Among them, cryptococcosis could be a life-threatening disease. We performed a Systematic Review (PRISMA Statement) of cryptococcosis and COVID-19 co-infection, case report/series were included: a total of 34 cases were found, then we added our case report. We collected patients' data and performed a statistical analysis comparing two groups of patients sorted by outcome: "dead" and "alive". Three cases were excluded for lack of information. To compare categorical data, we used a Fisher-exact test (α=0.05). To compare quantitative variables a U Mann-Whitney test was used (α=0.05), with a 95% Confidence Interval. A total of 32 co-infected patients were included in the statistical analysis. Mortality rate was 17/32 (53.1%): these patients were included in "dead" group, and 15/32 (46.9%) patients survived and were included in "alive" group. Overall, males were 25/32 (78.1%), the median age was 60 years (IQR 53-70) with non-statistically significant difference between groups (p=0.149 and p=0.911, respectively). Three variables were associated with mortality: ARDS, ICU admission and inadequate treatment. Overall, 21 out of 24 (87.5%) patients were in ARDS with a statistically significant difference among two groups (p=0.028). ICU admission for COVID-19 was observed in 18/26 (69.2%), more frequently among dead group (p=0.034). Finally, 15/32 (46.9%) patients had adequate treatment (amphotericin B + flucytosine for invasive cryptococcosis) mostly among alive patients (p=0.039). In conclusion, mortality due to cryptococcal infection among COVID-19 patients remains high but an early diagnosis and appropriate treatment could reduce mortality.
期刊介绍:
The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.