Epidemiological analysis of systemic mycoses in COVID-19

Abstract

Introduction. When analyzing constantly incoming information, it becomes clear that the growing risk of co-infections with a new coronavirus infection is the main threat of complications leading to death.Aim. A significant part of the information is the data accumulated by specialists on co-infections with systemic mycoses, which often causes a fatal outcome in coronavirus infection.Material and methods. In study systematized information about systemic mycoses in case of coronavirus infection, diagnosed according to the data of medical institutions in Vladivostok, specializing in the treatment of patients with a new coronavirus infection in the period from autumn 2020 to spring 2021.The results of a survey of 200 patients with a new coronavirus infection who were diagnosed with ventilator-associated pneumonia were studied.Results and discussion. Systemic mycoses in patients with COVID-19 do not create a relatively new situation: fungal-bacterial or viral-fungal co-infections were described even during the H1N1 or H7N9 influenza outbreaks. Almost all patients were treated with corticosteroids at high doses causing immunosuppression, which in turn contributed to the development of systemic mycosis. 26% (52 patients) were diagnosed with systemic mycoses, where the leading pathogens were fungi of the genus Aspergillus: A. niger, A terreus, A. fumigatus. The second place (15%, 30 patients) was occupied by representatives of the genus Candida, where C. albicans prevailed. All patients with diagnosed mycoses who were on treatment were prescribed, among other things, antimycotic therapy (voriconazole, fluconazole, caspofungin). However, all patients had a lethal outcome, which was determined by the combination of infection with the SARS-CoV-2 virus, and, ultimately, by the development of systemic mycosis, including the presence of concomitant pathology that determines the development of the infectious process.Conclusions. In the event of novel coronavirus infection, identification of associations of SARS-CoV-19 virus and other viruses combined with fungi also requires early clinical evaluation.