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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...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-9865967 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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