Invasive Aspergillosis in COVID-19: A Review Study and Recommendations for Diagnostic Approaches

Authors

  • Ashrafi Khozani, Mahtab PhD Student in Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  • Ghazanfari, Mona PhD Student in Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  • Hedayati, Mohammad Taghi Professor, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran 5 Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  • Maleki, Maedeh MSc in Medical Mycology, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  • Mortezaee, Vida PhD in Medical Mycology, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Abstract:

Background and purpose: COVID-19 is an emerging viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Bacterial or fungal superinfections of the lung may cause complications in clinical manifestations, treatment, and increase the mortality rate. In this article, we reviewed previous studies on invasive aspergillosis (IA) in viral infections and in adjustment with COVID-19. Also, the necessity of IA diagnosis to increase the survival rate in involved patients is discussed. Materials and methods: Electronic databases, including Pubmed, Google Scholar, and Web of Science were searched using the following keywords: COVID-19, SARS-CoV-2, influenza, invasive aspergillosis, and invasive fungal infections. Results: Reports from China showed 3.2% to 27.1% fungal co-infection in COVID-19 patients. Patients with COVID-19 who developed severe pneumonia were found with considerably higher rates of viral, bacterial, and fungal co-infections than those with mild pneumonia. Also, intestinal normal fungal flora was reported to be significantly different between COVID-19 patients and normal subjects. Conclusion: While the main focus of physicians is on bacterial superinfection control in COVID-19, ignoring life threatening fungal infections may increase the mortality rate. Therefore, we profoundly recommend early diagnosis of invasive fungal infections in COVID-19 patients.

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Journal title

volume 30  issue 184

pages  169- 178

publication date 2020-05

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