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1.
Mem. Inst. Oswaldo Cruz ; 116: e210207, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1463351

ABSTRACT

BACKGROUND Treatment of mycoses is often ineffective, usually prolonged, and has some side effects. These facts highlight the importance of discovering new molecules to treat fungal infections. OBJECTIVES To search the Medicines for Malaria Venture COVID Box for drugs with antifungal activity. METHODS Fourteen human pathogenic fungi were tested against the 160 drugs of this collection at 1.0 µM concentration. We evaluated the ability of the drugs to impair fungal growth, their fungicidal nature, and morphological changes caused to cells. FINDINGS Thirty-four molecules (21.25%) presented antifungal activity. Seven are antifungal drugs and one is the agricultural fungicide cycloheximide. The other drugs with antifungal activity included antibiotics (n = 3), antimalarials (n = 4), antivirals (n = 2), antiparasitcs (n = 3), antitumor agents (n = 5), nervous system agents (n = 3), immunosuppressants (n = 3), antivomiting (n = 1), antiasthmatic (n = 1), and a genetic disorder agent (n = 1). Several of these drugs inhibited Histoplasma capsulatum and Paracoccidioides brasiliensis growth (15 and 20, respectively), while Fusarium solani was not affected by the drugs tested. Most drugs were fungistatic, but niclosamide presented fungicidal activity against the three dimorphic fungi tested. Cyclosporine affected morphology of Cryptococcus neoformans. MAIN CONCLUSIONS These drugs represent new alternatives to the development of more accessible and effective therapies to treat human fungal infections.


Subject(s)
Humans , Pharmaceutical Preparations , Cryptococcus neoformans , COVID-19 , Malaria/drug therapy , Microbial Sensitivity Tests , Drug Repositioning , SARS-CoV-2 , Antifungal Agents/therapeutic use , Antifungal Agents/pharmacology
2.
Respir Med ; 188: 106619, 2021 11.
Article in English | MEDLINE | ID: covidwho-1415764

ABSTRACT

BACKGROUND: Invasive fungal infections (IFI) are increasing in prevalence in recent years. In the last few months, the rise of COVID-19 patients has generated a new escalation in patients presenting opportunistic mycoses, mainly by Aspergillus. Candida infections are not being reported yet. OBJECTIVES: We aimed to determine the prevalence of systemic candidiasis in patients admitted to ICUs due to severe pneumonia secondary to SARS-CoV-2 infection and the existence of possible associated risk factors that led these patients to develop candidiasis. PATIENTS/METHODS: We designed a study including patients with a confirmed diagnosis of COVID-19. RESULTS: The prevalence of systemic candidiasis was 14.4%, and the main isolated species were C. albicans and C. parapsilosis. All patients that were tested positive for Candida spp. stayed longer in the ICU in comparison to patients who tested negative. Patients with candidiasis had higher MuLBSTA score and mortality rates and a worse radiological involvement. In our study, Candida spp. isolates were found in patients that were submitted to: tocilizumab, tocilizumab plus systemic steroids, interferon type 1ß and Lopinavir-Ritonavir. CONCLUSIONS: Results suggested a high prevalence of systemic candidiasis in severe COVID-19-associated pneumonia patients. Patients with Candidiasis had the worst clinical outcomes. Treatment with tocilizumab could potentialize the risk to develop systemic candidiasis.


Subject(s)
COVID-19/complications , Candidiasis/epidemiology , Coinfection/epidemiology , Pneumonia/epidemiology , Aged , COVID-19/diagnosis , Candida albicans , Candida parapsilosis , Candidiasis/complications , Candidiasis/diagnosis , Coinfection/diagnosis , Critical Care , Female , Humans , Male , Middle Aged , Pneumonia/microbiology , Pneumonia/virology , Prevalence , Prospective Studies , Risk Factors
4.
Mycoses ; 64(2): 144-151, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-939797

ABSTRACT

BACKGROUND: As the global coronavirus pandemic (COVID-19) spreads across the world, new clinical challenges emerge in the hospital landscape. Among these challenges, the increased risk of coinfections is a major threat to the patients. Although still in a low number, due to the short time of the pandemic, studies that identified a significant number of hospitalised patients with COVID-19 who developed secondary fungal infections that led to serious complications and even death have been published. OBJECTIVES: In this scenario, we aim to determine the prevalence of invasive fungal infections (IFIs) and describe possible associated risk factors in patients admitted due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PATIENTS/METHODS: We designed an open prospective observational study at the Rey Juan Carlos University Hospital (Mostoles, Spain), during the period from February 1 to April 30, 2020. RESULTS: In this article, we reported seven patients with COVID-19-associated pulmonary aspergillosis (CAPA) who had a poor prognosis. Severely ill patients represent a high-risk group; therefore, we must actively investigate the possibility of aspergillosis in all of these patients. Larger cohort studies are needed to unravel the role of COVID-19 immunosuppressive therapy as a risk factor for aspergillosis. CONCLUSIONS: As the pandemic continues to spread across the world, further reports are needed to assess the frequency of emergent and highly resistant reemergent fungal infections during severe COVID-19. These coinfections are leading a significant number of patients with COVID-19 to death due to complications following the primary viral disease.


Subject(s)
COVID-19/complications , Invasive Pulmonary Aspergillosis/etiology , Opportunistic Infections/microbiology , Adult , Aged , Aspergillus/genetics , Aspergillus/isolation & purification , Aspergillus/physiology , COVID-19/virology , Female , Hospitalization , Humans , Intermediate Care Facilities/statistics & numerical data , Invasive Pulmonary Aspergillosis/microbiology , Male , Middle Aged , Opportunistic Infections/etiology , Prevalence , Prospective Studies , SARS-CoV-2/physiology , Spain
5.
Future Microbiol ; 15: 1405-1413, 2020 09.
Article in English | MEDLINE | ID: covidwho-883809

ABSTRACT

As the global COVID-19 pandemic spreads worldwide, new challenges arise in the clinical landscape. The need for reliable diagnostic methods, treatments and vaccines for COVID-19 is the major worldwide urgency. While these goals are especially important, the growing risk of co-infections is a major threat not only to the health systems but also to patients' lives. Although there is still not enough published statistical data, co-infections in COVID-19 patients found that a significant number of patients hospitalized with COVID-19 developed secondary systemic mycoses that led to serious complications and even death. This review will discuss some of these important findings with the major aim to warn the population about the high risk of concomitant systemic mycoses in individuals weakened by COVID-19.


Subject(s)
Coronavirus Infections/complications , Mycoses/complications , Opportunistic Infections/complications , Pneumonia, Viral/complications , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/pathology , Glucocorticoids/adverse effects , Humans , Invasive Fungal Infections/complications , Invasive Fungal Infections/diagnosis , Invasive Fungal Infections/epidemiology , Invasive Fungal Infections/microbiology , Lung Diseases, Fungal/complications , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/epidemiology , Lung Diseases, Fungal/microbiology , Mycoses/diagnosis , Mycoses/epidemiology , Mycoses/microbiology , Opportunistic Infections/diagnosis , Opportunistic Infections/epidemiology , Opportunistic Infections/microbiology , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/pathology , Risk , SARS-CoV-2
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