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Fungal Infections in Critically Ill COVID-19 Patients: Inevitabile Malum

Nikoletta Rovina1, Evangelia Koukaki1, Vasiliki Romanou1

  • 11st Department of Respiratory Medicine, Medical School, National and Kapodistrian University of Athens and "Sotiria" Chest Disease Hospital, 152 Mesogeion Ave, 11527 Athens, Greece.

Journal of Clinical Medicine
|April 12, 2022
PubMed

Insights

Critically ill COVID-19 patients face a high risk of invasive fungal infections (IFIs). This review examines IFIs

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Mycology

Background:

  • Severe COVID-19 patients exhibit high incidence (5-26.7%) of invasive fungal infections (IFIs).
  • Risk factors include organ failure, immunosuppressive therapy, mechanical ventilation, and SARS-CoV-2-induced immune dysfunction (e.g., reduced T-lymphocytes, cytokine storm).
  • The interplay between SARS-CoV-2 pathogenicity and immunosuppression in driving IFIs remains a critical question.

Purpose of the Study:

  • To identify the prevalence of IFIs in mechanically ventilated COVID-19 patients.
  • To determine risk factors associated with IFIs in this population.
  • To assess the mortality rates linked to IFIs in mechanically ventilated COVID-19 patients.

Main Methods:

  • Literature review approach.
  • Analysis of current scientific literature on IFIs in COVID-19.
  • Examination of SARS-CoV-2 pathogenicity and immunosuppressive therapy effects.

Main Results:

  • The review synthesizes data on IFI prevalence, ranging from 5% to 26.7% in critically ill COVID-19 patients.
  • Identified key risk factors including prolonged mechanical ventilation, organ failure, and specific treatments.
  • Highlighted the significant immune dysregulation caused by SARS-CoV-2 infection.

Conclusions:

  • Mechanically ventilated COVID-19 patients are a vulnerable group for IFIs.
  • Both viral factors and medical treatments contribute to increased IFI risk.
  • Further research is needed to elucidate the exact causal relationships and optimize patient management.
Keywords:
CACCAMCAPACOVID-19critically illfungal infections

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