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COVID-19 associated with cryptococcosis: a scoping review
Alvaro Quincho-Lopez1, Nuvith Poma2, Juan José Montenegro-Idrogo3,4,5
1Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
Therapeutic Advances in Infectious Disease
|February 16, 2024
Summary
COVID-19 patients can develop cryptococcosis, a serious fungal infection. This review found factors like male sex, older age, and ICU admission were linked to higher mortality in these cases.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Mycology
Background:
- Fungal infections, including cryptococcosis, are increasingly recognized in patients with COVID-19.
- While less common than other fungal coinfections, cryptococcosis in COVID-19 patients can be severe and life-threatening.
Purpose of the Study:
- To identify and analyze cases of cryptococcosis co-occurring with COVID-19.
- To compare characteristics and management strategies between survivors and non-survivors.
Main Methods:
- A comprehensive scoping review of multiple databases (PubMed, Scopus, Web of Science, Embase) was performed.
- Included studies were case reports, case series, and original articles, with no language restrictions.
- Data extraction focused on patient demographics, COVID-19 severity, cryptococcosis presentation, and outcomes.
Main Results:
- Analysis of 65 individual patient cases revealed a majority of males (73.9%) with a median age of 60 years.
- Severe COVID-19, comorbidities (hypertension, diabetes), intensive care unit (ICU) admission, and mechanical ventilation (MV) were common.
- Disseminated cryptococcosis occurred in 55.4% of patients, with an overall mortality rate of 47.7%.
Conclusions:
- Cryptococcosis is an emerging concern in COVID-19 patients, though not as prevalent as other fungal infections.
- Factors associated with mortality included male sex, advanced age, ICU admission, MV, secondary infections, and lymphopenia.
- Few COVID-19 patients with cryptococcosis presented with classic immunosuppression, highlighting the need for broader clinical suspicion.
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