Post-COVID-19 Fungal Infection in the Aged Population

Abstract

Coronavirus disease 2019 (COVID-19) infection is currently a great cause of concern for the healthcare sector around the globe. SARS-CoV-2 is an RNA virus that causes a serious infection that is associated with numerous adverse effects and multiple complications associated with different organs and systems during its pathogenic cycle in humans. Individuals affected by COVID-19, especially elderly populations and immunocompromised people, are greatly vulnerable to opportunistic fungal pathogens. Aspergillosis, invasive candidiasis, and mucormycosis are widespread fungal coinfections in COVID-19 patients. Other fungal infections that are rare but are exhibiting increased incidence in the current scenario include infections caused by Pneumocystis jirovecii, Histoplasma sp., Cryptococcus sp., etc. By producing virulent spores, these pathogens increase the severity of the disease and increase the morbidity and fatality rates in COVID-19 patients globally. These infections generally occur in patients recovering from COVID-19 infection, resulting in rehospitalization. Older and immunocompromised individuals are at higher risk of developing opportunistic fungal infections. This review focuses on understanding the opportunistic fungal infections prevalent in COVID-19 patients, especially elderly people. We have also highlighted the important preventive methods, diagnostic approaches, and prophylactic measures for fungal infections.

Insights on Covid‐19 with superimposed pulmonary histoplasmosis: The possible nexus

“…Furthermore, anti‐TNF‐α antagonist tocilizumab, effectively used in Covid‐19 patients to prevent cytokine storm, 70 increases the risk for activation of latent pulmonary histoplasmosis as reported in the case study 71 . Of interest, pulmonary histoplasmosis and other fungal infections could potentially cause rehospitalization in recovered patients from Covid‐19 pneumonia, mainly in elderly subjects due to post‐Covid‐19 syndrome 72 . Immune dysregulation in post‐Covid‐19 syndrome increases susceptibility to fungal infections.…”

“…Chavda et al 72 A retrospective study Invasive fungal infections were associated with Covid-19 severity. Cattneo et al 73 A case study Post-Covid-19 patients are associated with localized pulmonary histoplasmosis.…”

“… 71 Of interest, pulmonary histoplasmosis and other fungal infections could potentially cause rehospitalization in recovered patients from Covid‐19 pneumonia, mainly in elderly subjects due to post‐Covid‐19 syndrome. 72 Immune dysregulation in post‐Covid‐19 syndrome increases susceptibility to fungal infections. Besides, pulmonary histoplasmosis may develop after Covid‐19 pneumonia.…”

Synergy and Mechanism of Leflunomide Plus Fluconazole Against Resistant Candida albicans: An in vitro Study

“…[1][2][3] Even worse, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic globally raises the risk of fungal infections because the SARS-CoV-2 infection alters patients' immune and metabolic responses, which together creates an inflammatory environment that is highly conducive to fungal infections. [4][5][6] In response to the rising threat of fungal infections, as well as the existing and emerging resistance and treatability issues, WHO developed the first fungal priority pathogens list. 7 Among the list, Candida albicans (C. albicans) is assigned to the critical group, mainly given its antifungal resistance, mortality, evidence-based treatment, access to diagnostics, annual incidence and complications.…”

Use of Hand Sanitizers in COVID-19 Prevention: A Comprehensive Overview

“…It also renders the old and immunocompromised people susceptible to various co-infections, the prominent being opportunistic fungal pathogens. These co-infections have reportedly resulted in enhanced severity and increased mortality [4].…”