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Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves

Invasive fungal infections (IFIs) represent a severe complication of COVID-19, yet they are under-estimated. We conducted a retrospective analysis including all the COVID-19 patients admitted to the Infectious Diseases Unit of the Federico II University Hospital of Naples until the 1 July 2021. Amon...

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Autores principales: Cattaneo, Letizia, Buonomo, Antonio Riccardo, Iacovazzo, Carmine, Giaccone, Agnese, Scotto, Riccardo, Viceconte, Giulio, Mercinelli, Simona, Vargas, Maria, Roscetto, Emanuela, Cacciatore, Francesco, Salvatore, Paola, Catania, Maria Rosaria, Villari, Riccardo, Cittadini, Antonio, Gentile, Ivan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865967/
https://www.ncbi.nlm.nih.gov/pubmed/36675909
http://dx.doi.org/10.3390/jof9010086
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author Cattaneo, Letizia
Buonomo, Antonio Riccardo
Iacovazzo, Carmine
Giaccone, Agnese
Scotto, Riccardo
Viceconte, Giulio
Mercinelli, Simona
Vargas, Maria
Roscetto, Emanuela
Cacciatore, Francesco
Salvatore, Paola
Catania, Maria Rosaria
Villari, Riccardo
Cittadini, Antonio
Gentile, Ivan
author_facet Cattaneo, Letizia
Buonomo, Antonio Riccardo
Iacovazzo, Carmine
Giaccone, Agnese
Scotto, Riccardo
Viceconte, Giulio
Mercinelli, Simona
Vargas, Maria
Roscetto, Emanuela
Cacciatore, Francesco
Salvatore, Paola
Catania, Maria Rosaria
Villari, Riccardo
Cittadini, Antonio
Gentile, Ivan
author_sort Cattaneo, Letizia
collection PubMed
description Invasive fungal infections (IFIs) represent a severe complication of COVID-19, yet they are under-estimated. We conducted a retrospective analysis including all the COVID-19 patients admitted to the Infectious Diseases Unit of the Federico II University Hospital of Naples until the 1 July 2021. Among 409 patients, we reported seven cases of IFIs by Candida spp., seven of Pneumocystis jirovecii pneumonia, three of invasive pulmonary aspergillosis, and one of Trichosporon asahii. None of the cases presented underlying predisposing conditions, excluding one oncohematological patient treated with rituximab. Ten cases showed lymphopenia with high rates of CD4+ < 200/µL. All cases received high-dose steroid therapy (mean duration 33 days, mean cumulative dosage 1015 mg of prednisone equivalent), and seven cases had severe COVID-19 disease (OSCI ≥ 5) prior to IFI diagnosis. The cases showed a higher overall duration of hospitalization (63 vs 24 days) and higher mortality rate (23% vs. 7%) compared with the COVID-19 patients who did not developed IFIs. Cases showed a higher prevalence of high-dose steroid therapy and lymphopenia with CD4+ < 200/µL, primarily due to SARS-CoV-2 infection and not related to underlying comorbidities. IFIs strongly impact the overall length of hospitalization and mortality. Therefore, clinicians should maintain a high degree of suspicion of IFIs, especially in severe COVID-19 patients.
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spelling pubmed-98659672023-01-22 Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves Cattaneo, Letizia Buonomo, Antonio Riccardo Iacovazzo, Carmine Giaccone, Agnese Scotto, Riccardo Viceconte, Giulio Mercinelli, Simona Vargas, Maria Roscetto, Emanuela Cacciatore, Francesco Salvatore, Paola Catania, Maria Rosaria Villari, Riccardo Cittadini, Antonio Gentile, Ivan J Fungi (Basel) Article Invasive fungal infections (IFIs) represent a severe complication of COVID-19, yet they are under-estimated. We conducted a retrospective analysis including all the COVID-19 patients admitted to the Infectious Diseases Unit of the Federico II University Hospital of Naples until the 1 July 2021. Among 409 patients, we reported seven cases of IFIs by Candida spp., seven of Pneumocystis jirovecii pneumonia, three of invasive pulmonary aspergillosis, and one of Trichosporon asahii. None of the cases presented underlying predisposing conditions, excluding one oncohematological patient treated with rituximab. Ten cases showed lymphopenia with high rates of CD4+ < 200/µL. All cases received high-dose steroid therapy (mean duration 33 days, mean cumulative dosage 1015 mg of prednisone equivalent), and seven cases had severe COVID-19 disease (OSCI ≥ 5) prior to IFI diagnosis. The cases showed a higher overall duration of hospitalization (63 vs 24 days) and higher mortality rate (23% vs. 7%) compared with the COVID-19 patients who did not developed IFIs. Cases showed a higher prevalence of high-dose steroid therapy and lymphopenia with CD4+ < 200/µL, primarily due to SARS-CoV-2 infection and not related to underlying comorbidities. IFIs strongly impact the overall length of hospitalization and mortality. Therefore, clinicians should maintain a high degree of suspicion of IFIs, especially in severe COVID-19 patients. MDPI 2023-01-06 /pmc/articles/PMC9865967/ /pubmed/36675909 http://dx.doi.org/10.3390/jof9010086 Text en © 2023 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 Article
Cattaneo, Letizia
Buonomo, Antonio Riccardo
Iacovazzo, Carmine
Giaccone, Agnese
Scotto, Riccardo
Viceconte, Giulio
Mercinelli, Simona
Vargas, Maria
Roscetto, Emanuela
Cacciatore, Francesco
Salvatore, Paola
Catania, Maria Rosaria
Villari, Riccardo
Cittadini, Antonio
Gentile, Ivan
Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves
title Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves
title_full Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves
title_fullStr Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves
title_full_unstemmed Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves
title_short Invasive Fungal Infections in Hospitalized Patients with COVID-19: A Non-Intensive Care Single-Centre Experience during the First Pandemic Waves
title_sort invasive fungal infections in hospitalized patients with covid-19: a non-intensive care single-centre experience during the first pandemic waves
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865967/
https://www.ncbi.nlm.nih.gov/pubmed/36675909
http://dx.doi.org/10.3390/jof9010086
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