Urinary Tract infections: Urinary Schistosomiasis

Urogenital schistosomiasis is a neglected tropical disease affecting approximately a quarter of a million people in the world. A lot of research on the disease has focused on school age children with very limited studies in preschool age children (PSAC). Schistosome control programs targeting PSAC should take into consideration other factors affecting this age group such as malnutrition, co-infections, underlying inflammatory conditions as well as the fact that this is the age group receiving childhood vaccinations. Praziquantel is the only drug currently being used for the treatment of schistosomiasis. However, there needs to be more research on the appropriate dosage and safety for the PSAC. Allergic conditions have been shown to be less prevalent in areas where parasitic infections are prevalent. When carrying out mass drug administration (MDA) programs considerations on the effects of treatment on allergy should be taken. COVID-19 has affected MDA programs and continues to do so. The lessons learnt and effects of COVID-19 on schistosomiasis need to be investigated. © 2022 Elsevier Inc. All rights reserved.

Surveillance of Influenza and Other Airborne Transmission Viruses during the 2021/2022 Season in Hospitalized Subjects in Tuscany, Italy.

Winter in the northern hemisphere is characterized by the circulation of influenza viruses, which cause seasonal epidemics, generally from October to April. Each influenza season has its own pattern, which differs from one year to the next in terms of the first influenza case notification, the period of highest incidence, and the predominant influenza virus subtypes. After the total absence of influenza viruses in the 2020/2021 season, cases of influenza were again recorded in the 2021/2022 season, although they remained below the seasonal average. Moreover, the co-circulation of the influenza virus and the SARS-CoV-2 pandemic virus was also reported. In the context of the DRIVE study, oropharyngeal swabs were collected from 129 Tuscan adults hospitalized for severe acute respiratory infection (SARI) and analyzed by means of real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 and 21 different airborne pathogens, including influenza viruses. In total, 55 subjects tested positive for COVID-19, 9 tested positive for influenza, and 3 tested positive for both SARS-CoV-2 and the A/H3N2 influenza virus. The co-circulation of different viruses in the population requires strengthened surveillance that is no longer restricted to the winter months. Indeed, constant, year-long monitoring of the trends of these viruses is needed, especially in at-risk groups and elderly people.

Incidence of SARS-CoV-2 Co-infections During the Second Wave in Sub-Himalayan Region, India.

Introduction The second wave of the coronavirus disease 2019 (COVID-19) pandemic in India, which started from April 2021, has been more severe and deadly than the first wave. The aim of this prospective study was to determine the possibility of other respiratory pathogens contributing towards the severity and hospitalization in the current second wave. Materials and methods Nasopharyngeal and oropharyngeal swab samples were collected and processed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR). These samples were further processed for detection of co-infection in SARS CoV-2 patients by BioFire® Filmarray® 2.0 (bioMérieux, USA). Results We screened 77 COVID-19-positive patients admitted to All India Institute of Medical Sciences (AIIMS), Rishikesh and found cases of co-infections in five (6.49 %) patients. Conclusion Our finding suggests that co-infections had no or minimal role in augmenting the second wave of the COVID-19 pandemic in India, and the emergence of new variants may be the probable cause.

Bacterial Co-Infections and Antimicrobial Resistance in Patients Hospitalized with Suspected or Confirmed COVID-19 Pneumonia in Kazakhstan.

Our study was carried out to characterize respiratory tract microbiota in patients with "COVID-like pneumonia" in Kazakhstan and analyze differences between COVID-19 positive and negative groups. Sputum samples were collected from hospitalized patients, ≥18 years old, in the three cities in Kazakhstan with the highest COVID-19 burden in July 2020. Isolates were identified by MALDI-TOF MS. Susceptibility testing was performed by disk diffusion. We used SPSS 26 and MedCalc 19 for statistical analysis. Among 209 patients with pneumonia, the median age was 62 years and 55% were male. RT-PCR-confirmed SARS-CoV-2 cases were found in 40% of patients, and 46% had a bacterial co-infection. Co-infection was not associated with SARS-CoV-2 RT-PCR test results, but antibiotic use was. The most frequent bacteria were Klebsiella pneumoniae (23%), Escherichia coli (12%), and Acinetobacter baumannii (11%). Notably, 68% of Klebsiella pneumoniae had phenotypic evidence of extended-spectrum beta-lactamases in disk diffusion assays, 87% of Acinetobacter baumannii exhibited resistance to beta-lactams, and >50% of E. coli strains had evidence of ESBL production and 64% were resistant to fluoroquinolones. Patients with a bacterial co-infection had a higher proportion of severe disease than those without a co-infection. The results reinforce the importance of using appropriate targeted antibiotics and effective infection control practices to prevent the spread of resistant nosocomial infections.

Microbial and clinical epidemiology of invasive fungal rhinosinusitis in hospitalized COVID-19 patients, the divergent causative agents.

Since COVID-19 spread worldwide, invasive fungal rhinosinusitis (IFRS) has emerged in immunocompromised patients as a new clinical challenge. In this study, clinical specimens of 89 COVID-19 patients who presented clinical and radiological evidence suggestive of IFRS were examined by direct microscopy, histopathology, and culture, and the isolated colonies were identified through DNA sequence analysis. Fungal elements were microscopically observed in 84.27% of the patients. Males (53.9%) and patients over 40 (95.5%) were more commonly affected than others. Headache (94.4%) and retro-orbital pain (87.6%) were the most common symptoms, followed by ptosis/proptosis/eyelid swelling (52.8%), and 74 patients underwent surgery and debridement. The most common predisposing factors were steroid therapy (n = 83, 93.3%), diabetes mellitus (n = 63, 70.8%), and hypertension (n = 42, 47.2%). The culture was positive for 60.67% of the confirmed cases, and Mucorales were the most prevalent (48.14%) causative fungal agents. Different species of Aspergillus (29.63%) and Fusarium (3.7%) and a mix of two filamentous fungi (16.67%) were other causative agents. For 21 patients, no growth was seen in culture despite a positive result on microscopic examinations. In PCR-sequencing of 53 isolates, divergent fungal taxons, including 8 genera and 17 species, were identified as followed: Rhizopus oryzae (n = 22), Aspergillus flavus (n = 10), A. fumigatus (n = 4), A. niger (n = 3), R. microsporus (n = 2), Mucor circinelloides, Lichtheimia ramosa, Apophysomyces variabilis, A. tubingensis, A. alliaceus, A. nidulans, A. calidoustus, Fusarium fujikuroi/proliferatum, F. oxysporum, F. solani, Lomentospora prolificans, and Candida albicans (each n = 1). In conclusion, a diverse set of species involved in COVID-19-associated IFRS was observed in this study. Our data encourage specialist physicians to consider the possibility of involving various species in IFRS in immunocompromised and COVID-19 patients. In light of utilizing molecular identification approaches, the current knowledge of microbial epidemiology of invasive fungal infections, especially IFRS, may change dramatically.

Invasive fungal rhinosinusitis (IFRS) may infect people with diabetes, cancer, or COVID-19. In this study, various types of fungi were identified from COVID-19-associated-IFRS, encouraging physicians to consider specific treatments.

Viral co-infection with human respiratory syncytial virus in suspected acute and severe respiratory tract infections during COVID-19 pandemic in Yaoundé, Cameroon, 2020-2021.

BACKGROUND: Acute lower respiratory tract infections (ALRIs) are one one of the leading causes of morbidity and mortality among people of all ages worldwide, particularly in low- and middle-income countries (LMICs). The purpose of this study was to determine epidemiological characteristics of respiratory viruses in acute respiratory infection (ARI) patients during the COVID-19 pandemic in Yaoundé, Cameroon. METHODS: Patients were monitored for respiratory symptoms as part of the surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viral infections. Patients of all ages with respiratory symptoms less than 5 days were considered. Sociodemographic and clinical data as well as nasopharyngeal samples was collected from patients. Nasopharyngeal samples were tested for SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) using real-time reverse-transcription polymerase chain reaction methods. Virus distribution and demographic data were analyzed with R version 2.15.1. RESULTS: From July 2020 to October 2021, 1120 patients were included. The overall viral detection rate was 32.5%, including 9.5% for RSV, 12.6% for influenza virus and 12.8% for SARS-CoV-2. Co-infections were detected in 6.9% of positive cases. While RSV and influenza virus showed seasonal trends, SARS-CoV-2 was detected throughout the study period. CONCLUSION: We found that during COVID-19 pandemic, respiratory viruses play an important role in etiology of influenza-like illness in Cameroon, and this observation was true for patients of all ages.

Can photocatalysis help in the fight against COVID-19 pandemic?

Mould fungi are serious threats to humans and animals (allergen) and might be the main cause of COVID-19-associated pulmonary aspergillosis. The common methods of disinfection are not highly effective against fungi due to the high resistance of fungal spores. Recently, photocatalysis has attracted significant attention towards antimicrobial action. Outstanding properties of titania photocatalysts have already been used in many areas, e.g., for building materials, air conditioner filters, and air purifiers. Here, the efficiency of photocatalytic methods to remove fungi and bacteria (risk factors for Severe Acute Respiratory Syndrome Coronavirus 2 co-infection) is presented. Based on the relevant literature and own experience, there is no doubt that photocatalysis might help in the fight against microorganisms, and thus prevent the severity of COVID-19 pandemic.

Global asymptotic stability, extinction and ergodic stationary distribution in a stochastic model for dual variants of SARS-CoV-2

Several mathematical models have been developed to investigate the dynamics SARS-CoV-2 and its different variants. Most of the multi-strain SARS-CoV-2 models do not capture an important and more realistic feature of such models known as randomness. As the dynamical behavior of most epidemics, especially SARS-CoV-2, is unarguably influenced by several random factors, it is appropriate to consider a stochastic vaccination co-infection model for two strains of SARS-CoV-2. In this work, a new stochastic model for two variants of SARS-CoV-2 is presented. The conditions of existence and the uniqueness of a unique global solution of the stochastic model are derived. Constructing an appropriate Lyapunov function, the conditions for the stochastic system to fluctuate around endemic equilibrium of the deterministic system are derived. Stationary distribution and ergodicity for the new co-infection model are also studied. Numerical simulations are carried out to validate theoretical results. It is observed that when the white noise intensities are larger than certain thresholds and the associated stochastic reproduction numbers are less than unity, both strains die out and go into extinction with unit probability. More-over, it is observed that, for weak white noise intensities, the solution of the stochastic system fluctuates around the endemic equilibrium (EE) of the deterministic model. Frequency distributions are also studied to show random fluctuations due to stochastic white noise intensities. The results presented herein also reveal the impact of vaccination in reducing the co-circulation of SARS-CoV-2 variants within a given population. © 2022 International Association for Mathematics and Computers in Simulation (IMACS)

Co-infection associated with SARS-CoV-2 and their management.

SARS-CoV-2 was discovered in Wuhan, China and quickly spread throughout the world. This deadly virus moved from person to person, resulting in severe pneumonia, fever, chills and hypoxia. Patients are still experiencing problems after recovering from COVID-19. This review covers COVID-19 and associated issues following recovery from COVID-19, as well as multiorgan damage risk factors and treatment techniques. Several unusual illnesses, including mucormycosis, white fungus infection, happy hypoxia and other systemic abnormalities, have been reported in recovered individuals. In children, multisystem inflammatory syndrome with COVID-19 (MIS-C) is identified. The reasons for this might include uncontrollable steroid usage, reduced immunity, uncontrollable diabetes mellitus and inadequate care following COVID-19 recovery.

COVID-19 infection has reported in the development several other infections and co-morbidity in patients. The present review discusses risk and management strategies in patients suffeting from co-infections caused by COVID-19 infection.

Impact of Bacterial Infections on COVID-19 Patients: Is Timing Important?

BACKGROUND: Along with important factors that worsen the clinical outcome of COVID-19, it has been described that bacterial infections among patients positive for a SARS-CoV-2 infection can play a dramatic role in the disease process. Co-infections or community-acquired infections are recognized within the first 48 h after the admission of patients. Superinfections occur at least 48 h after admission and are considered to contribute to a worse prognosis. Microbiologic parameters differentiate infections that happen after the fifth day of hospitalization from those appearing earlier. Specifically, after the fifth day, the detection of resistant bacteria increases and difficult microorganisms emerge. OBJECTIVES: The aim of the study was to evaluate the impact of bacterial infections in patients with COVID-19 on the length of the hospital stay and mortality. METHODS: A total of 177 patients hospitalized due to COVID-19 pneumonia were consecutively sampled during the third and fourth wave of the pandemic at a University Hospital in Greece. A confirmed bacterial infection was defined as positive blood, urinary, bronchoalveolar lavage (BAL) or any other infected body fluid. Patients with confirmed infections were further divided into subgroups according to the time from admission to the positive culture result. RESULTS: When comparing the groups of patients, those with a confirmed infection had increased odds of death (odds ratio: 3.634; CI 95%: 1.795-7.358; p < 0.001) and a longer length of hospital stay (median 13 vs. 7 days). A late onset of infection was the most common finding in our cohort and was an independent risk factor for in-hospital death. Mortality and the length of hospital stay significantly differed between the subgroups. CONCLUSION: In this case series, microbial infections were an independent risk factor for a worse outcome among patients with COVID-19. Further, a correlation between the onset of infection and a negative outcome in terms of non-infected, community-acquired, early hospital-acquired and late hospital-acquired infections was identified. Late hospital-acquired infections increased the mortality of COVID-19 patients whilst superinfections were responsible for an extended length of hospital stay.

COVID­19 and peritonsillar abscess co­infection: A case report.

Coronavirus disease 2019 (COVID-19) generally presents with fever, shortness of breath and a sore throat. These symptoms are also common in oral and pharyngeal infections, such as peritonsillar abscess (PA). The present study describes a case of PA and COVID-19 co-infection. Although COVID-19 was initially suspected in the patient due to the presenting symptoms of fever, sore throat, dysgeusia and dysosmia, an oral examination and computed tomography scan detected PA. The patient was conservatively managed with intravenous antibiotics without transoral drainage of the abscess. Anti-COVID-19 medication was not administered as the COVID-19 infection in the patient was not severe. Laboratory findings revealed high levels of leukocytes, C-reactive protein (CRP) and procalcitonin. On the whole, the association between laboratory findings (including leukocyte count, CRP and procalcitonin levels) and bacterial co-infection with COVID-19 remains unclear, and further studies are warranted. Oral examinations and transoral procedures are often avoided due to the high risk of the aerosolisation of COVID-19 viral particles. However, an appropriate evaluation is essential in order to avoid the underdiagnosis of life-threatening bacterial infections that co-exist with COVID-19.

Staphylococcal Scalded Skin Syndrome Superinfection in a Child with COVID-19: A Brief Case Report

Background: While the exact prevalence of bacterial co-infection and superinfection in children with coronavirus disease 2019 (COVID-19) remains unclear, numerous scattered reports of it are on the rise. Case Presentation: Our case was a 14-month-old infant with fever, truncal erythema, and scalded skin in flexor folds and also in perianal and perioral regions. A positive Nikolsky's sign was observed. The oropharyngeal mucosa was intact. The patient was diagnosed with staphylococcal scalded skin syndrome (SSSS) according to clinical features and a skin culture report. Due to the general impact of COVID-19 these days, the patient was evaluated for coronavirus via a polymerase chain reaction (PCR) test, and the result was positive. The patient successfully responded to the treatment which included hydration, wet compress, topical emollient, topical mupirocin for periorificial regions, and intravenous clindamycin. He was discharged after nine days without any complications. Conclusion(s): This case highlights a clear bacterial infection superimposed on COVID-19. Nevertheless, inconspicuous cases of co-infections remain obscure and require a more diagnostic suspicion. Copyright © 2022 Hoseininasab et al.

HIV and SARS-CoV-2 Co-Infection: From Population Study Evidence to In Vitro Studies.

Human immunodeficiency virus type 1 (HIV-1) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have caused two major viral outbreaks during the last century. Two major aspects of HIV-1 and SARS-CoV-2 co-infection have been extensively investigated and deserve attention. First, the impact of the co-infection on the progression of disease caused by HIV-1 or SARS-CoV-2. Second, the impact of the HIV-1 anti-retroviral treatment on SARS-CoV-2 infection. In this review, we aim to summarize and discuss the works produced since the beginning of the SARS-CoV-2 pandemic ranging from clinical studies to in vitro experiments in the context of co-infection and drug development.

Bacterial Opportunist Pathogens in ICU Patients and COVID-19 Pandemic

Introduction. The COVID-19 infection caused by SARS-CoV-2 is often severe and can lead to fatal outcomes. It is known that the main route of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is airborne. Studies revealed that up to 25% of subjects from at-risk groups who have been affected by severe viral respiratory infections acquired secondary bacterial infections. These individuals have been reported to have superinfections and co-infections with SARS-CoV-2. Numerous opportunistic infections have been identified in patients with COVID-19, including the major bacterial pathogens responsible for healthcare-associated infections. The prevalence, frequency, and characteristics of bacterial agents isolated in patients during the COVID-19 pandemic are poorly understood and are considered to be a significant gap in knowledge. Therefore, it seemed appropriate to perform a comparative analysis of changes in the structure of bacterial etiological agents in patients hospitalized in intensive care units before and during the COVID-19 pandemic. Purpose. To review research and to study the structure of opportunistic bacterial agents isolated in hospitalized patients and to evaluate the impact of the COVID-19 pandemic impact on changes in incidence and characteristics of the main opportunistic infectious agents compared to the same period before the pandemic. Materials and methods. Bacteria were isolated and identified by conventional bacteriological methods using a variety of biochemical series, test systems for identification, as well as with the use of an automatic hemocultivator, a microbiological analyzer, and a mass spectrometer. The analysis includes data from the WHONET database of the centralized microbiological laboratory of the city of Minsk regarding the test results of blood and respiratory samples from adult patients hospitalized in intensive care units. A comparative analysis of the structure of etiological agents was carried out quarterly for two equal time periods. It's important to note that any bacteria detected from sources other than the respiratory tract or bloodstream was excluded from this data. In addition, all the data received from the intensive care units (ICUs) were analyzed apart from data obtained in other units. Results. The results of respiratory and blood samples of 52,530 patients have been analyzed. A comparative analysis of the structure of microorganisms isolated from 33,539 samples (63.8%, CI95% 63.6–64.0) was performed. In addition, isolates classified as of opportunistic bacterial pathogens were identified in samples of 20,053 patients (59.8%, CI95% 59.5–61.1). It was found that during the COVID-19 pandemic there was a 2.6–fold increase in the number of patients with blood samples tested and a 1.8–fold increase in the number of patients with respiratory specimens tested. The most frequent isolate from both blood samples (pre-pandemic 20.2% (CI95% 19.0–21.4) and 19.9% (CI95% 19.3–20.5) during the pandemic) and respiratory specimens (pre-pandemic 39.0% (CI95% 38.0–40.0) and 40.6% (CI95% 39.9–41.3) during the pandemic) was K. pneumoniae. At the same time, the structure of bacterial agents was modified due to increasing prevalence of non-fermenting gram-negative bacteria. Thus, the frequency of A. baumannii isolated from blood samples increased by 1.8 times, and those isolated from respiratory specimens by 1.3 times. For K. pneumoniae an increase in resistance frequency against penicillins, 3rd-and 4th-generation cephalosporins, carbapenems, fluoroquinolones, colistin, tetracycline, and tigecycline was established;for A. baumannii isolated from blood samples an increase in resistance frequency against gentamicin, tobramycin, and colistin was revealed, and for those from respiratory specimens an increase in resistance frequency against imipenem, meropenem, and tetracycline was revealed during the pandemic. Conclusion. An increase in frequency of isolation of gram-negative pathogens was established. It was indirectly confirmed that co-infection a d or superinfection with K. pneumoniae and A. baumannii and other opportunistic bacteria characterized by multiple resistance to antibacterial drugs, could increase the risks of severe course of underlying disease and lead to lethal outcomes. Prevention of secondary bacterial infections in ICU patients, including those diagnosed with COVID-19, requires an improvement in prevention programs, infection control practices and antibiotic therapy management systems. © 2022, Professionalnye Izdaniya. All rights reserved.

Co-Infections and Secondary Infections with Multidrug-Resistant Bacteria in COVID-19 Infected Individuals: A Review

Bacterial co-infections and secondary infections are common in respiratory viral infections. Since COVID-19 is a respiratory viral infection proportion of the bacterial infections are high which leads to significant mortality. If these organisms were Multidrug resistance (MDR) the situation become worse. In this mini-review, we analyze the bacterial co-infections& secondary infections, and MDR status in COVID-19 individuals Method: This mini-review was reviewed from articles published in PubMed, Scopus, and Google scholar indexed journals between January 2021 to January 2022. The keywords used for the search were "secondary bacterial infections in COVID-19 individuals", "MDR resistant bacteria in COVID-19", and "case reports on MDR infections in COVID-19 patients" Results: the proportion of bacterial co-infections and secondary infections are varied from region to region as low as 2.5% to 95% reported. MDR strains are high. Conclusion(s): Unnecessary use of antibiotics, prolonged hospital stay, and overburden on the health care system are the main reasons for increasing MDR strains. Copyright © 2022 Japan University of Health Sciences.

Co-infections in Hospitalized COVID-19 Patients- A Prospective Observational Study.

INTRODUCTION: SARS -CoV-2 was first reported in Wuhan and declared a pandemic in March 2020. Co-infections during other pandemics have been associated with severe outcomes, but data are scarce regarding co-infections in COVID-19 patients. Our study evaluated co-infections prevalence and its impact on morbidity and mortality in hospitalized COVID -19 patients. METHODS: This prospective observational study included 100 patients admitted to a high-dependency unit at a tertiary care hospital in India. Prevalence of co-infections and clinical outcome-related data were analyzed in COVID-19 patients satisfying the inclusion criteria. RESULTS: 14% of patients had co-infections, out of which urinary tract infection was found in 9%. Patients with co-infections had a higher mortality rate (p<0.0004). Urinary co-infection emerged as an independent risk factor for mortality (p <0.001). CONCLUSION: Co-infections associated with COVID-19 infections are an essential risk factor for morbidity and mortality. Early identification and timely treatment of co-infections may help in improving clinical outcomes.

COVID-19-Associated Fungal Infections: An Urgent Need for Alternative Therapeutic Approach?

Secondary fungal infections may complicate the clinical course of patients affected by viral respiratory diseases, especially those admitted to intensive care unit. Hospitalized COVID-19 patients are at increased risk of fungal co-infections exacerbating the prognosis of disease due to misdiagnosis that often result in treatment failure and high mortality rate. COVID-19-associated fungal infections caused by predominantly Aspergillus and Candida species, and fungi of the order Mucorales have been reported from several countries to become significant challenge for healthcare system. Early diagnosis and adequate antifungal therapy is essential to improve clinical outcomes, however, drug resistance shows a rising trend highlighting the need for alternative therapeutic agents. The purpose of this review is to summarize the current knowledge on COVID-19-associated mycoses, treatment strategies and the most recent advancements in antifungal drug development focusing on peptides with antifungal activity.

Role of Intracellular Pulmonary Pathogens during SARS-CoV-2 Infection in the First Pandemic Wave of COVID-19: Clinical and Prognostic Significance in a Case Series of 1200 Patients.

Background: Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (COVID-19) has caused millions of deaths worldwide and is the second most serious pandemic after the Spanish flu. Despite SARS-CoV-2 infection having a dominant effect on morbidity and life-threatening outcomes, the role of bacterial co-infection in patients with COVID-19 is poorly understood. The present study aimed to verify the existence of bacterial co-infections and their possible role as cofactors worsening COVID-19-related clinical manifestations. Methods: All patients with suspected SARS-CoV-infection, hospitalised in COVID-19 wards at the Sant'Anna University Hospital of Ferrara, were retrospectively included in this single-centre study and their specific bacterial serologies were assessed. Univariate and logistic regression analyses were performed. Results: A total of 1204 individual records were retrieved. Among them, 959 were excluded because of a negative nasopharyngeal swab or missing data; of the eligible 245 patients, 51 were co-infected. Compared to patients with SARS-CoV-2 infection alone, those with Chlamydia pneumoniae or Mycoplasma pneumoniae co-infections had worse respiratory/radiological features and more intensive care unit admissions. However, the co-infection did not result in a higher mortality rate. Conclusions: The present study, comparing clinical, laboratory and radiological findings between patients with COVID-19 vs. those with co-infections (C. pneumoniae or M. pneumoniae) showed that, on admission, these features were worse in co-infected patients, although the mortality rate did not differ between the two groups.

Intestinal mucormycosis in a patient with COVID-19: A case report.

The novel coronavirus disease (COVID-19) has spread to all the continents posing a serious threat to global health. It can present with myriad symptoms and complications including susceptibility to fungal co-infections. We hereby describe a case of mucormycosis in a 17 year old COVID-19 positive female with no known comorbidities presenting with abdominal pain and distention and ultimately developing intestinal perforation. Early identication of the symptoms is essential to make a correct and early diagnosis to prevent complications.

Risk factors for mortality in kidney transplant recipients with COVID-19: a single centre experience and case-control study.

BACKGROUND: COVID-19 infection is considered to cause high mortality in kidney transplant recipients (KTR). Old age, comorbidities and acute kidney injury are known risk factors for increased mortality in KTR. Nevertheless, mortality rates have varied across different regions. Differences in age, comorbidities and varying standards of care across geographies may explain some variations. However, it is still unclear whether post-transplant duration, induction therapy, antirejection therapy and co-infections contribute to increased mortality in KTR with COVID-19. The present study assessed risk factors in a large cohort from India. METHODS: A matched case-control study was performed to analyze risk factors for death in KTR (N = 218) diagnosed with COVID-19 between April 2020 to July 2021 at the study centre. Cases were KTR who died (non-survivors, N = 30), whereas those who survived were taken as controls (survivors, N = 188). RESULTS: A high death-to-case ratio of 13.8% was observed amongst study group KTR infected with COVID-19. There was a high incidence (12.4%) of co-infections, with cytomegalovirus being the most common co-infection among non-survivors. Diarrhea, co-infection, high oxygen requirement, and need for mechanical ventilation were significantly associated with mortality on regression analyses. Antirejection therapy, lymphopenia and requirement for renal replacement therapy were associated with worse outcomes. CONCLUSIONS: The mortality was much higher in KTR who required mechanical ventilation and had co-infections. Mortality did not vary with the type of transplant, post-transplant duration and usage of depletion induction therapy. An aggressive approach has to be taken for an early diagnosis and therapeutic intervention of associated infections.