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

Jingwen Peng1,2, Qiong Wang1,2, Huan Mei1,2

  • 1Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, China.

Aging
|March 21, 2021
PubMed

Insights

Fungal co-infections are present in 12% of COVID-19 patients, increasing mortality risk. This meta-analysis highlights the need to consider antifungal therapy in treating COVID-19 patients with fungal infections.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) has caused a global health crisis.
  • The incidence and impact of fungal co-infections in COVID-19 patients are not well-established.
  • Understanding these co-infections is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To systematically investigate the association between fungal co-infection and mortality in COVID-19 patients.
  • To determine the pooled proportion of fungal co-infections among COVID-19 cases.
  • To assess the mortality rate in COVID-19 patients with concurrent fungal infections.

Main Methods:

  • Systematic literature search of Medline, Embase, MedRxiv, and Cochrane Library (January 1 – December 1, 2020).
  • Meta-analysis of nine eligible studies.
  • Inclusion of data from 2780 COVID-19 patients, with a subset of 426 in Intensive Care Units (ICUs).

Main Results:

  • The overall pooled proportion of fungal co-infection in COVID-19 patients was 12% (95% CI = 0.07-0.16).
  • The pooled proportion of mortality among COVID-19 patients with fungal infection was 17% (95% CI = 0.10-0.24).
  • Overall mortality rate among COVID-19 patients in the included studies was 10.9%.

Conclusions:

  • Fungal co-infection is a significant concern in COVID-19 patients, associated with increased mortality.
  • The findings support the consideration of empirical antibiotic use in most COVID-19 cases.
  • This analysis serves as a reference for evaluating the role of antifungal therapy in COVID-19 treatment.
Keywords:
COVID-19fungal co-infectionmeta-analysissystematic review

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