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COVID-19-associated opportunistic infections: a snapshot on the current reports
Amir Abdoli1,2, Shahab Falahi3, Azra Kenarkoohi4
1Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran. a.abdoli25@gmail.com.
Abstract:
Treatment of the novel Coronavirus Disease 2019 (COVID-19) remains a complicated challenge, especially among patients with severe disease. In recent studies, immunosuppressive therapy has shown promising results for control of the cytokine storm syndrome (CSS) in severe cases of COVID-19. However, it is well documented that immunosuppressive agents (e.g., corticosteroids and cytokine blockers) increase the risk of opportunistic infections. On the other hand, several opportunistic infections were reported in COVID-19 patients, including Aspergillus spp., Candida spp., Cryptococcus neoformans, Pneumocystis jiroveci (carinii), mucormycosis, Cytomegalovirus (CMV), Herpes simplex virus (HSV), Strongyloides stercoralis, Mycobacterium tuberculosis, and Toxoplasma gondii. This review is a snapshot about the main opportunistic infections that reported among COVID-19 patients. As such, we summarized information about the main immunosuppressive agents that were used in recent clinical trials for COVID-19 patients and the risk of opportunistic infections following these treatments. We also discussed about the main challenges regarding diagnosis and treatment of COVID-19-associated opportunistic infections (CAOIs).
Insights
Severe COVID-19 treatments using immunosuppressive therapy can control cytokine storm syndrome but increase the risk of opportunistic infections. This review summarizes these infections and diagnostic challenges in COVID-19 patients.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Severe COVID-19 presents challenges, with immunosuppressive therapies showing promise for cytokine storm syndrome (CSS).
- However, immunosuppressive agents increase the risk of opportunistic infections (OIs).
- Various OIs have been documented in COVID-19 patients.
Purpose of the Study:
- To review opportunistic infections reported in COVID-19 patients.
- To summarize immunosuppressive agents used in COVID-19 trials and their associated OI risks.
- To discuss diagnostic and treatment challenges of COVID-19-associated opportunistic infections (CAOIs).
Main Methods:
- Literature review of studies on COVID-19 treatments and opportunistic infections.
- Synthesis of information on immunosuppressive agents and their impact on OI risk.
- Analysis of reported cases of opportunistic infections in COVID-19 patients.
Main Results:
- Immunosuppressive therapies for severe COVID-19 are linked to increased opportunistic infection rates.
- Common opportunistic infections include fungal (Aspergillus, Candida, Cryptococcus, Mucormycosis), viral (CMV, HSV), and parasitic infections.
- Challenges exist in diagnosing and treating these co-infections.
Conclusions:
- Immunosuppressive treatment for severe COVID-19 necessitates careful monitoring for opportunistic infections.
- Early diagnosis and appropriate management are crucial for improving outcomes in patients with CAOIs.
- Further research is needed to optimize treatment strategies balancing immunosuppression and infection prevention.
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