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There are a number of new studies that are showing that COVID-19 patients are at increased risk and or already suffering from a fungal infection. For example, some patients who have been admitted to the hospital with severe COVID-19 pneumonia were found to have pulmonary aspergillosis (CAPA), a fungal (mold) lung infection.

It was reported in July that the President of Brazil, Jair Bolsonaro had contracted the coronavirus and he later made an online video about “mold” in his lungs, having spent weeks in isolation after catching the virus. Bosnaro had said, “”I just did a blood test. I was feeling kind of weak yesterday. They found a bit of infection also. Now I’m on antibiotics,” Bolsonaro said in a livestream video, without elaborating on the infection.”

“After 20 days indoors, I have other problems. I have mold in my lungs,” he said. (1)

In April 2020, researchers had begun to signal warnings that fungal infections in COVID-19 patients were a serious threat that was receiving inadequate attention from medical authorities. The study concluded that the complication of bacterial or fungal infection was not included in the prognosis of COVID-19 patients and that medical professionals are missing a secondary infection that is found in 50% of non-surviving COVID-19 patients. (2)

A study from August 2020 found that Aspergillus species were isolated from tracheal aspirates of nine (39.1%) patients, and of these, five patients (21.7%) were diagnosed with CAPA and four (17.4%) had Aspergillus colonization with an overall fatality rate of COVID-19 patients with aspergillosis was 44%. The researches concluded that there is an association of aspergillosis and COVID-19 and the need for screening for fungal infections in severe COVID-19 patients with certain risk factors. (3)

A new study from July 2020 has found that a growing number of fungal co-infections may also be associated with global COVID-19 pandemic that might be missed or misdiagnosed. The researchers stated that COVID-19 patients who are severely ill or immunocompromised, have a higher probability of suffering from invasive mycoses.

Invasive mycosis is when molds (fungi) enter the body via the lungs, through the gut, paranasal sinuses, or the skin through dermal absorption. The most common molds that cause opportunistic mycoses are Candida, Cryptococcus (Valley Fever), Pneumocystis, and Aspergillus.

These molds can then spread via the bloodstream to multiple organs including the skin, lungs, abdominal viscera, bones, and or central nervous system. The most common portals of entry are the respiratory tract, gastrointestinal tract, and blood vessels often causing multiple organs to fail and eventually resulting in the death of the patient.

For example, severe COVID-19 patients who have other immune impairment factors are being treated with broad-spectrum antibacterial drugs, parenteral nutrition, and invasive examinations, which may cause the risk of infection with Candida species to significantly increase.

The researchers discovered that COVID-19 patients showed overexpression of inflammatory cytokines, and impaired cell-mediated immune response, indicating its susceptibility to fungal co-infection accompanied with an immunocompromised state.

The study concluded that assessments for invasive mycosis in clinical settings and the need for standard or individualized treatment in COVID-19 patients will help assist the clinicians and laboratory experts in the management of aspergillosis, candidiasis, mucormycosis, or cryptococcosis as comorbidities in COVID-19 patients. (4)

SOURCES:

1. Yahoo News

2. Bacterial and fungal infections in COVID-19 patients: A matter of concern

3. COVID-19-associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID-19 pneumonia: An observational study from Pakistan

4. Fungal Co-infections Associated with Global COVID-19 Pandemic: A Clinical and Diagnostic Perspective from China

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