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COVID-19 in patients with paracoccidioidomycosis
Priscila Marques de Macedo1, Lorena Macedo Pestana Benko1, Eduardo Mastrangelo Marinho Falcão1
1Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
Introduction:
In 2020, we reported the first patient with concomitant COVID-19 and paracoccidioidomycosis (PCM). Since then, no other cases have been recorded in the literature. We aim to update information on the occurrence of COVID-19 in patients with PCM followed at a reference center for infectious diseases at Rio de Janeiro, Brazil.
Methods:
We reviewed the medical records from patients diagnosed with PCM who presented with clinical symptoms, radiological findings, and/or laboratory diagnosis of COVID-19 at any time during their acute or follow-up care. The clinical profiles of these patients were described.
Results:
Between March 2020 and September 2022, we identified six individuals with COVID-19 among the 117 patients with PCM evaluated. The median age was 38 years and the male to female ratio 2:1. Most patients (n = 5) presented for evaluation due to acute PCM. The severity of COVID-19 ranged from mild to severe in acute PCM and only the single patient with chronic PCM died.
Conclusions:
There is a range of disease severity in COVID-19 and PCM co-infection and concomitant disease may represent a severe association, especially in the chronic type of the mycosis with pulmonary involvement. As COVID-19 and chronic PCM share similar clinical aspects and PCM is neglected, it is probable that COVID-19 has been hampering simultaneous PCM diagnosis, which can explain the absence of new co-infection reports. With the continued persistence of COVID-19 globally, these findings further suggest that more attention by providers is necessary to identify co-infections with Paracoccidioides.
Insights
Six patients with COVID-19 and paracoccidioidomycosis (PCM) were identified between 2020-2022. Co-infection can be severe, particularly in chronic PCM, highlighting the need for increased clinical vigilance.
Area of Science:
- Infectious Diseases
- Mycology
- Pulmonology
Background:
- The first case of concomitant COVID-19 and paracoccidioidomycosis (PCM) was reported in 2020.
- No further cases have been documented in scientific literature since.
- This study updates the occurrence of COVID-19 in PCM patients at a Brazilian infectious disease reference center.
Approach:
- A retrospective review of medical records was conducted.
- Patients diagnosed with PCM and presenting with COVID-19 (clinically, radiologically, or by laboratory tests) were included.
- Clinical profiles of these co-infected patients were analyzed.
Key Points:
- Six individuals with COVID-19 were identified among 117 PCM patients between March 2020 and September 2022.
- The median age of co-infected patients was 38 years, with a 2:1 male to female ratio.
- COVID-19 severity varied; the single patient with chronic PCM and pulmonary involvement died.
Conclusions:
- Co-infection with COVID-19 and PCM can lead to severe disease, especially in chronic pulmonary cases.
- Overlapping symptoms may hinder simultaneous diagnosis of PCM and COVID-19, potentially explaining the scarcity of reported cases.
- Increased provider awareness is crucial for identifying COVID-19 and Paracoccidioides co-infections.
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