Aspergillus-SARS-CoV-2 Coinfection: What Is Known?

Carlos Alberto Castro-Fuentes1, María Del Rocío Reyes-Montes1, María Guadalupe Frías-De-León2

  • 1Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico.

Insights

COVID-19-associated pulmonary aspergillosis (CAPA) is common and linked to longer hospital stays. This review identifies fungal, environmental, and host factors, plus SARS-CoV-2

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • COVID-19-associated pulmonary aspergillosis (CAPA) presents a significant clinical challenge with high incidence and prolonged hospitalizations.
  • Numerous factors contribute to CAPA development, including fungal characteristics, hospital environment, host comorbidities, and immunosuppressive treatments.
  • SARS-CoV-2 infection itself severely impairs both innate and adaptive immunity, characterized by reduced T cell counts and cytokine storm.

Purpose of the Study:

  • To identify factors influencing fungal coinfection in SARS-CoV-2 patients.
  • To analyze predisposing factors related to the fungus, host, and immune response alterations in CAPA development.
  • To elucidate the complex interplay leading to CAPA.

Main Methods:

  • This is a review article.
  • Literature search and synthesis of existing studies on CAPA.
  • Analysis of fungal, host, and viral (SARS-CoV-2) related factors.

Main Results:

  • Fungal factors include organism virulence and colonization ability.
  • Environmental factors in hospitals and patient comorbidities play a role.
  • SARS-CoV-2 induced immune dysfunction, including T cell reduction and cytokine storm, is a critical predisposing factor.

Conclusions:

  • Understanding the multifactorial nature of CAPA is crucial for clinical management.
  • Targeting fungal, host, and immune response factors may mitigate CAPA risk.
  • Further research is needed to develop effective prevention and treatment strategies for CAPA.

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