Pneumonia During the COVID-19 Pandemic in Hubei Province, China: a Case Report of Mucormycosis

Wu, Jianguo; Song, Jiangqin; Hu, Fuying; Li, Huashun; Tian, Youjun; Cheng, Weijia; Liu, Ying; Luo, Qian

doi:10.7754/clin.lab.2022.220905

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“…Although mNGS has disadvantages such as its high cost, susceptibility to exogenous microbial contamination, and reduced efficiency in detecting thick-walled fungi, research has showcased its superior sensitivity and specificity in diagnosing invasive fungal diseases compared to traditional culture and histopathological methods ( El-Kamand et al., 2019 ; Song et al., 2021 ; Wang et al., 2022 ). In certain circumstances, mNGS has a superior positive detection efficiency and can determine fungal pathogens that are difficult to diagnose via conventional diagnostic approaches ( Zheng et al., 2021 ; Wu et al., 2023 ).…”

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confidence: 99%

COVID-19 in pulmonary critically ill patients: metagenomic identification of fungi and characterization of pathogenic microorganisms

Huang,

Chang,

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundFungal co-infection is prevalent in critically ill patients with COVID-19. The conventional approach applied to fungal identification has relatively low sensitivity and is time-consuming. The metagenomic next-generation sequencing (mNGS) technology can simultaneously detect a variety of microorganisms, and is increasingly being used for the rapid detection and diagnosis of pathogens.MethodsIn this single-center retrospective study, we described the clinical presentation and outcomes of COVID-19 and mNGS positive for fungi in pulmonary critically ill patients during the outbreak of Omicron infection from December 2022 to January 2023.ResultsAmong 43 COVID-19 patients with acute respiratory distress syndrome (ARDS) on a single intensive care unit (ICU), 10 were reported to be fungal positive using the mNGS test. The number of pathogenic microorganisms detected by mNGS was significantly higher than that via traditional methods, especially in the detection of fungi and viruses. Aspergillus infection was dominant, and most of these patients also had concurrent bacterial or viral infections. Probable or possible COVID-19-associated pulmonary aspergillosis (CAPA) was diagnosed in all 10 patients, and the prognosis was poor.ConclusionPatients with COVID-19 may be at increased risk of developing fungal infections as well as concurrent bacterial or viral infections, and mNGS can be a powerful tool in identifying these infections. Clinicians should be aware of the increased risk of fungal infections in COVID-19 patients, particularly those who have underlying immunocompromising conditions, and should monitor for early signs of infection.

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