COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

Chan, Khee‐Siang; Lai, Chih‐Cheng; Yu, Wen-Liang; Chao, Chien‐Ming

doi:10.3390/jof8101111

Cited by 6 publications

(7 citation statements)

References 59 publications

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“… 48 In the present study, six isolates were MDR, of which four were reported in cryptococcal fungemia, indicating the severity of cryptococcemia. 49 The high numbers of NWT isolates were reported against amphotericin B (8.96%), similar to a previous study reported from China, in which 8.6% of isolates were NWT. However, the proportion of NWT isolates against 5-flucytosine and fluconazole in the present study is lower than the previously published literature from China.…”

Section: Discussionsupporting

confidence: 88%

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Bilal,

Zhang,

Shafiq

et al. 2023

IDR

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Objective Cryptococcosis is a fatal infection that can affect both immunocompetent and immunocompromised patients, and it is little understood in China’s various regions. This research aimed to look at the epidemiology, risk factors, and antifungal susceptibility pattern of Cryptococcus neoformans in eastern Guangdong, China. Methods A six-year (2016–2022) retrospective study was conducted at Meizhou People’s Hospital, China. Demographical, clinical, and laboratory data of cryptococcal patients were collected from hospital records and statistically analyzed using the chi-square and ANOVA tests. Results Overall, 170 cryptococcal infections were recorded, of which meningitis accounted for 78 (45.88%), cryptococcemia for 50 (29.41%), and pneumonia for 42 (24.7%). The number of cases increased 8-fold during the study duration. The median age of patients was 58 years (Inter quartile range: 47–66), and the high proportion of cases was from the male population (n = 121, 71.17%). The underlying diseases were identified only in 60 (35.29%) patients, of which 26 (15.29%) were severely immunocompromised, and 26 (15.29%) others were mildly immunocompromised. A statistically significant difference was reported for chronic renal failure, and anemia ( p < 0.05) persisted in cases of three infection types. A high number of non-wild type (NWT) isolates were found against amphotericin B (n=13/145, 8.96%), followed by itraconazole (n=7/136, 5.15%) and voriconazole (n=4/158, 2.53%). Only six isolates (3.79%) were multidrug-resistant, four of which were from cryptococcemia patients. Compared to meningitis and pneumonia, cryptococcemia revealed a higher percentage of NWT isolates ( p < 0.05). Conclusion In high-risk populations, cryptococcal infections require ongoing monitoring and management.

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Section: Discussionsupporting

confidence: 88%

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Bilal,

Zhang,

Shafiq

et al. 2023

IDR

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“…Overall, cryptococcosis in COVID-19 patients is not as frequent compared to other fungal infections such as mucormycosis 70 and aspergillosis, 71 widely reported in the literature, in COVID-19 patients, although it can still be life-threatening in light of the high mortality, ranging between 50% and 65%. 23 , 50 , 72 , 73 Our analysis showed that the majority of patients were men and around 60 years of age, and in addition, it was determined that both male sex and age are risk factors associated with mortality. The male sex is related to the incidence, severity, and mortality of COVID-19.…”

Section: Discussionmentioning

confidence: 88%

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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“…Twenty-one patients had HIV infection in reports described by US researchers [57]. Chan and reseachers [58] reported 18 cases of COVID-19 infections associated with cryptococcosis, isolating C. neoformans and C. laurentii in their case series; these researchers, in summary, emphasized that COVID-19-associated cryptococcosis is uncommon; however, it may be underestimated due to underdiagnosis.…”

Section: Reports Of Immunosuppression In Cases Of Sars-covmentioning

confidence: 96%

Challenges of the Global COVID-19 Pandemic and Invasive Fungal Pathogens in SARS-COV-2 Associations: A Dangerous Relationship

Mariscal¹,

Matias²,

Almeida³

et al. 2023

AiM

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Background: COVID-19 is a rapidly transmissible pneumonia-like illness caused by SARS-CoV-2 that out broke in China in 2019 and is currently circulating worldwide. In the current context of the SARS-CoV-2 pandemic, complications are observed in clinical settings for the treatment of severe COVID-19 disease in nosocomial settings, due to cases of fungal co-infections. Objective: To carry out a review on fungal infections associated with respiratory infections caused by COVID-19 (Sars-Cov-2) and their aggravation. Methodology: The purpose of this study is to inform the reader about the characteristics of SARS-CoV-2 and the main fungal species that are affecting patients undergoing treatment for severe COVID-19, provoking discussion of the importance of the proposed topic, in relation to co-infections by different fungal microorganisms. Result: 80 scientific studies were selected, resulting from patients with COVID-19 and most commonly observed in patients with a history of comorbidities such as diabetes mellitus, hypertension, kidney disease, severe liver disease, oncological diseases, obesity and with severe COVID-19. These data do not represent the total number of records of the disease in the world, but cases reported by researchers in their series, showing the overlapping of fungal co-infection through the compromised immune status due to the use of therapeutic drugs, dysregulation of the microbiota, How to cite this paper: Mariscal, A.

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COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

Cited by 6 publications

References 59 publications

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

COVID-19 associated with cryptococcosis: a scoping review

Challenges of the Global COVID-19 Pandemic and Invasive Fungal Pathogens in SARS-COV-2 Associations: A Dangerous Relationship

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