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Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients

Patients with coronavirus disease 19 (COVID-19) admitted to the intensive care unit (ICU) often develop respiratory fungal infections. The most frequent diseases are the COVID-19 associated pulmonary aspergillosis (CAPA), COVID-19 associated pulmonary mucormycosis (CAPM) and the Pneumocystis jirovec...

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Autores principales: Raffaelli, Francesca, Tanzarella, Eloisa Sofia, De Pascale, Gennaro, Tumbarello, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025868/
https://www.ncbi.nlm.nih.gov/pubmed/35448646
http://dx.doi.org/10.3390/jof8040415
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author Raffaelli, Francesca
Tanzarella, Eloisa Sofia
De Pascale, Gennaro
Tumbarello, Mario
author_facet Raffaelli, Francesca
Tanzarella, Eloisa Sofia
De Pascale, Gennaro
Tumbarello, Mario
author_sort Raffaelli, Francesca
collection PubMed
description Patients with coronavirus disease 19 (COVID-19) admitted to the intensive care unit (ICU) often develop respiratory fungal infections. The most frequent diseases are the COVID-19 associated pulmonary aspergillosis (CAPA), COVID-19 associated pulmonary mucormycosis (CAPM) and the Pneumocystis jirovecii pneumonia (PCP), the latter mostly found in patients with both COVID-19 and underlying HIV infection. Furthermore, co-infections due to less common mold pathogens have been also described. Respiratory fungal infections in critically ill patients are promoted by multiple risk factors, including epithelial damage caused by COVID-19 infection, mechanical ventilation and immunosuppression, mainly induced by corticosteroids and immunomodulators. In COVID-19 patients, a correct discrimination between fungal colonization and infection is challenging, further hampered by sampling difficulties and by the low reliability of diagnostic approaches, frequently needing an integration of clinical, radiological and microbiological features. Several antifungal drugs are currently available, but the development of new molecules with reduced toxicity, less drug-interactions and potentially active on difficult to treat strains, is highly warranted. Finally, the role of prophylaxis in certain COVID-19 populations is still controversial and must be further investigated.
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spelling pubmed-90258682022-04-23 Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients Raffaelli, Francesca Tanzarella, Eloisa Sofia De Pascale, Gennaro Tumbarello, Mario J Fungi (Basel) Review Patients with coronavirus disease 19 (COVID-19) admitted to the intensive care unit (ICU) often develop respiratory fungal infections. The most frequent diseases are the COVID-19 associated pulmonary aspergillosis (CAPA), COVID-19 associated pulmonary mucormycosis (CAPM) and the Pneumocystis jirovecii pneumonia (PCP), the latter mostly found in patients with both COVID-19 and underlying HIV infection. Furthermore, co-infections due to less common mold pathogens have been also described. Respiratory fungal infections in critically ill patients are promoted by multiple risk factors, including epithelial damage caused by COVID-19 infection, mechanical ventilation and immunosuppression, mainly induced by corticosteroids and immunomodulators. In COVID-19 patients, a correct discrimination between fungal colonization and infection is challenging, further hampered by sampling difficulties and by the low reliability of diagnostic approaches, frequently needing an integration of clinical, radiological and microbiological features. Several antifungal drugs are currently available, but the development of new molecules with reduced toxicity, less drug-interactions and potentially active on difficult to treat strains, is highly warranted. Finally, the role of prophylaxis in certain COVID-19 populations is still controversial and must be further investigated. MDPI 2022-04-17 /pmc/articles/PMC9025868/ /pubmed/35448646 http://dx.doi.org/10.3390/jof8040415 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Raffaelli, Francesca
Tanzarella, Eloisa Sofia
De Pascale, Gennaro
Tumbarello, Mario
Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
title Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
title_full Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
title_fullStr Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
title_full_unstemmed Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
title_short Invasive Respiratory Fungal Infections in COVID-19 Critically Ill Patients
title_sort invasive respiratory fungal infections in covid-19 critically ill patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025868/
https://www.ncbi.nlm.nih.gov/pubmed/35448646
http://dx.doi.org/10.3390/jof8040415
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