Fungal co-infection in COVID-19 patients: evidence from a systematic review and meta-analysis

Peng, Jingwen; Wang, Qiong; Mei, Huan; Zheng, Hailin; Liang, Guangzhao; She, Xiaodong; Liu, Weida

doi:10.18632/aging.202742

Cited by 46 publications

(45 citation statements)

References 19 publications

(21 reference statements)

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“…The unusual incidence of bacterial or fungal infections in our study differs from other published studies (9) (19). This significant finding is due to the participant characteristics of critically ill patients receiving therapy via invasive catheters and being at risk of infection by nosocomial pathogens.…”

Section: Discussioncontrasting

confidence: 98%

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Bacterial and Fungal Co-Infections among ICU COVID-19 Hospitalized Patients in a Palestinian Hospital: Incidence and Antimicrobial Stewardship

shtaya

Mohammad

Al-Shami

et al. 2021

Preprint

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Diagnosis of co-infections with multiple pathogens among hospitalized COVID-19 patients can be jointly challenging and very essential for appropriate treatment, shortening hospital stay and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single centre cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine. The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged ≥20 years, with a confirmed diagnosis of COVID-19 via RT-PCR conducted on a nasopharyngeal swab. The patient's information was gathered using graded data forms from electronic medical reports. The diagnosis of bacterial and fungal infection was proved through the patient`s clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the ICU admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates (Enterobacter species and K.pneumoniae). The rate of fungal co-infection caused by A.fumigatus was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental.

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Section: Discussioncontrasting

confidence: 98%

“…After fungal culturing at admission, 0.12%- 0.15% of the cases were positive for fungal infection and Asian patients were more likely to acquire fungal co-infection. The infecting fungi include Aspergillus, Candida, Cryptococcus neoformans, Pneumocystis, or other fungal species (9).…”

Section: Introductionmentioning

confidence: 99%

Bacterial and Fungal Co-Infections among ICU COVID-19 Hospitalized Patients in a Palestinian Hospital: Incidence and Antimicrobial Stewardship

shtaya

Mohammad

Al-Shami

et al. 2021

Preprint

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“…The present meta-analysis revealed that the pooled prevalence of CAM among hospitalised COVID-19 patients was 7 cases per 1000 patients. In their comprehensive review of fungal coinfections among COVID-19 cohorts, Peng et al (2021) found that the pooled prevalence of all fungal coinfections was 12 cases per 1000 patients, with a statistically significant difference between Asian (15 cases per 1000 patients) and European populations (7 cases per 1000 patients) [65]. The pooled prevalence of COVID-19-associated pulmonary aspergillosis (CAPA) was 6 cases per 1000 patients, which was slightly similar to what we have found in terms of CAM prevalence, and the difference between Asian (13 cases per 1000 patients) and European populations (0.1 cases per 1000 patients) was statistically significant [65].…”

Section: Discussionmentioning

confidence: 99%

Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis

Hussain

Riad

Singh

et al. 2021

JoF

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Mucormycosis, a secondary fungal infection, gained much attention in the ongoing COVID-19 pandemic. This deadly infection has a high all-cause mortality rate and imposes a significant economic, epidemiological, and humanistic burden on the patients and healthcare system. Evidence from the published epidemiological studies showed the varying prevalence of COVID-19-associated mucormycosis (CAM). This study aims to compute the pooled prevalence of CAM and other associated clinical outcomes. MEDLINE, Embase, Cochrane COVID-19 Study Register, and WHO COVID-19 databases were scanned to retrieve the relevant articles until August 2021. All studies reporting the prevalence of mucormycosis among COVID-19 patients were eligible for inclusion. Two investigators independently screened the articles against the selection criteria, extracted the data, and performed the quality assessment using the JBI tool. The pooled prevalence of CAM was the primary outcome, and the pooled prevalence of diabetes, steroid exposure, and the mortality rate were the secondary outcomes of interest. Comprehensive Meta-Analysis software version 2 was used for performing the meta-analysis. This meta-analysis comprised six studies with a pooled sample size of 52,916 COVID-19 patients with a mean age of 62.12 ± 9.69 years. The mean duration of mucormycosis onset was 14.59 ± 6.88 days after the COVID-19 diagnosis. The pooled prevalence of CAM (seven cases per 1000 patients) was 50 times higher than the highest recorded background of mucormycosis (0.14 cases per 1000 patients). A high mortality rate was found among CAM patients with a pooled prevalence rate of 29.6% (95% CI: 17.2–45.9%). Optimal glycemic control and the judicious use of steroids should be the approach for tackling rising CAM cases.

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“…In this regard, it is worth highlighting that the ongoing pandemic by SARS-CoV-2 dramatically increased the number of hospitalizations. This condition further contributed to the development of Candida opportunistic infections, exacerbating the consequences of fungal infections in a context characterized by highly susceptible patients [ 61 , 62 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-Candidal Activity of the Parasitic Plant Orobanche crenata Forssk

et al. 2021

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Candida albicans (C. albicans) and Candida glabrata (C. glabrata) are part of the human microbiome. However, they possess numerous virulence factors, which confer them the ability to cause both local and systemic infections. Candidiasis can involve multiple organs, including the eye. In the present study, we investigated the anti-candidal activity and the re-epithelizing effect of Orobanche crenata leaf extract (OCLE). By the microdilution method, we demonstrated an inhibitory effect of OCLE on both C. albicans and C. glabrata growth. By crystal violet and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, we showed the ability of OCLE to inhibit the biofilm formation and the viability of yeast cells, respectively. By germ tube and adhesion assays, we proved the capacity of OCLE to affect the morphological transition of C. albicans and the adhesion of both pathogens to human retinal pigment epithelial cells (ARPE-19), respectively. Besides, by MTT and wound healing assay, we evaluated the cytotoxic and re-epithelizing effects of OCLE on ARPE-19. Finally, the Folin–Ciocalteu and the ultra-performance liquid chromatography-tandem mass spectrometry revealed a high content of phenols and the presence of several bioactive molecules in the extract. Our results highlighted new properties of O. crenata, useful in the control of Candida infections.

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Fungal co-infection in COVID-19 patients: evidence from a systematic review and meta-analysis

Cited by 46 publications

References 19 publications

Bacterial and Fungal Co-Infections among ICU COVID-19 Hospitalized Patients in a Palestinian Hospital: Incidence and Antimicrobial Stewardship

Bacterial and Fungal Co-Infections among ICU COVID-19 Hospitalized Patients in a Palestinian Hospital: Incidence and Antimicrobial Stewardship

Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis

Anti-Candidal Activity of the Parasitic Plant Orobanche crenata Forssk

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