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Pneumocystis pneumonia in COVID-19 patients: A comprehensive review

Elahe Sasani1, Fares Bahrami2,3, Mohammadreza Salehi4,5

  • 1Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Heliyon
|February 15, 2023
PubMed

Insights

Opportunistic fungal infections like Pneumocystis pneumonia (PCP) complicate COVID-19 care. Low lymphocyte counts and corticosteroid use are key risk factors, necessitating vigilant PCP prophylaxis in high-risk intensive care unit patients.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Mycology

Background:

  • Patients in intensive care units with coronavirus disease 2019 (COVID-19) are susceptible to secondary infections.
  • Opportunistic fungal infections, particularly Pneumocystis pneumonia (PCP), are significant contributors to COVID-19 severity and mortality.

Purpose of the Study:

  • To review existing literature on COVID-19 patients diagnosed with Pneumocystis pneumonia (PCP).
  • To identify the distinct features and risk factors associated with PCP in the context of COVID-19.

Main Methods:

  • Literature review of studies focusing on COVID-19 patients co-infected with Pneumocystis pneumonia (PCP).
  • Analysis of patient characteristics, risk factors, and clinical presentations reported in the selected studies.

Main Results:

  • Pneumocystis pneumonia (PCP) occurred in both immunocompromised and immunocompetent COVID-19 patients, with the latter developing immunosuppression during treatment.
  • Major risk factors for PCP in COVID-19 patients included lymphocytopenia (low lymphocyte counts) and corticosteroid therapy.
  • Clinical and radiological findings of PCP and COVID-19 pneumonia often overlap, complicating diagnosis and treatment.

Conclusions:

  • Pneumocystis pneumonia (PCP) presents a diagnostic and therapeutic challenge in COVID-19 patients due to overlapping symptoms.
  • Physicians must proactively assess high-risk COVID-19 patients for PCP, considering risk factors like lymphocytopenia and corticosteroid use.
  • Comprehensive evaluation and consideration for PCP prophylaxis are crucial for managing severe COVID-19 cases.
Keywords:
COVID-19Pneumocystosis pneumoniaSARS-CoV-2

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