Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru

Huamani-Córdova, Juana M.; Hueda-Zavaleta, Miguel; Vargas-Bellina, Victor; Simbron-Ribbeck, Lourdes; Chong-Chinchay, Katty del Rosario; Torre, Juan C. Gómez de la; Benítes-Zapata, Vicente A.

doi:10.3390/tropicalmed8030182

Cited by 2 publications

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References 15 publications

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“…Of the total number of patients, the male sex was affected in 48 cases while the median age was 60 years, with statistically significant differences between the two groups: alive versus dead in both variables ( p value = 0.0203 and 0.0332, respectively). Of 60 patients with available information, 31 were from the United States 15 , 16 , 19 – 40 (51.6%), 8 from Peru 41 (13.3%), 7 from Brazil 14 , 42 – 47 (11.6%), and 2 from India 48 , 49 and Italy 50 , 51 (3.3% each), while the rest were from Canada, 52 Colombia, 53 China, 54 the Czech Republic, 55 the UK, 56 Uganda, 57 Qatar, 58 Lebanon, 59 Spain, 60 and Germany 61 ( n = 1; 1.7% each).…”

Section: Resultsmentioning

confidence: 99%

COVID-19 associated with cryptococcosis: a scoping review

Quincho-Lopez,

Poma,

José Montenegro-Idrogo

2024

Therapeutic Advances in Infection

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Background: There is growing evidence of fungal infections associated with COVID-19. The development of cryptococcosis in these patients has been infrequently reported. However, it can be life-threatening. Objective: To identify cases of COVID-19 patients who developed cryptococcosis and to compare baseline characteristics and management between those who survived and those who died. Methods: We conducted a scoping review using PubMed, Scopus, Web of Science, and Embase to identify studies that reported patients with COVID-19 and cryptococcosis. No language restriction was applied. Single case reports, case series, and original articles were included. It is important to note that ‘ n’ refers to the total number of individuals with the specified variable. Results: A total of 58 studies were included. Among these studies, 51 included individual patient data, detailing information on a total of 65 patients, whereas eight studies reported the proportion of cryptococcosis in COVID-19 patients. One study provided both individual and aggregate case information. From individual patient data, the majority were male (73.9%; n = 48) with a median age of 60 years (range: 53–70). Severe COVID-19 and multiple comorbidities, led by arterial hypertension and diabetes mellitus, were frequently reported, but few had classic immunosuppression factors. On the other hand, HIV status, either negative or positive, was reported in just over half of the patients (61.5%; n = 40). Most were admitted to the intensive care unit (ICU) (58.5%; n = 31), received mechanical ventilation (MV) (50.0%; n = 26), and developed disseminated cryptococcosis (55.4%; n = 36). Secondary infection, mainly bacterial, was reported in 19 patients (29.2%). Mortality was 47.7% ( n = 31). Of the studies that reported the proportion of cryptococcosis in COVID-19 cases, the majority were descriptive studies published as conference abstracts. Conclusion: Cryptococcosis in COVID-19 patients has been reported more frequently. However, it is still not as common as other fungal infections associated with COVID-19. Few patients have some classic immunosuppression factors. The factors associated with mortality were male sex, age, ICU admission, MV, secondary infections, and lymphopenia.

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Section: Resultsmentioning

confidence: 99%

COVID-19 associated with cryptococcosis: a scoping review

Quincho-Lopez,

Poma,

José Montenegro-Idrogo

2024

Therapeutic Advances in Infection

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“…It has been reported that these LC patients present persistent immunological dysfunction, characterized by highly active innate cells, depletion of B and T cells (including CD4 and CD8 T lymphocytes), and high expression of Interferon (IFN)-β and IFN-λ1. 7 , 8 Generally, CD4+/CD8+ T lymphocytes produce IFN-γ, which is a potent promoter of the fungicidal activity of macrophages 9 ; this CD4 lymphopenia can last even 75 days after acute infection 10 ; hence, its depletion could be related to a greater risk of infections such as Mucormycosis, Cryptococcosis, and P. jirovecii in patients recovered from COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Fungal infections in patients after recovering from COVID-19: a systematic review

Ulloque-Badaracco,

Copaja-Corzo,

Hernandez-Bustamante

et al. 2024

Therapeutic Advances in Infection

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Background and aims: The presence of fungal infections has been described in patients after recovering from COVID-19. This study aims to conduct a systematic review of studies that reported fungal infections ( Mucor spp., Pneumocystis jirovecii, or Aspergillus spp.) in adults after recovering from COVID-19. Methods: We performed a systematic review through PubMed, Web of Science, OVID-Medline, Embase, and Scopus. The study selection process was performed independently and by at least two authors. We performed a risk of bias assessment using the Newcastle–Ottawa Scale for cohort and case–control studies, and the Joanna Briggs Institute’s Checklists for Case Series and Case Reports. Results: The systematic search found 33 studies meeting all inclusion criteria. There was a total population of 774 participants, ranging from 21 to 87 years. From them, 746 developed a fungal infection. In 19 studies, Mucor spp. was reported as the main mycosis. In 10 studies, P. jirovecii was reported as the main mycosis. In seven studies, Aspergillus spp. was reported as the main mycosis. Regarding the quality assessment, 12 studies were classified as low risk of bias and the remaining studies as high risk of bias. Conclusion: Patients’ clinical presentation and prognosis after recovering from COVID-19 with fungal infection differ from those reported patients with acute COVID-19 infection and those without COVID-19 infection.

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Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru

Cited by 2 publications

References 15 publications

COVID-19 associated with cryptococcosis: a scoping review

COVID-19 associated with cryptococcosis: a scoping review

Fungal infections in patients after recovering from COVID-19: a systematic review

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