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1.
Frontiers in Cellular and Infection Microbiology ; 12, 2022.
Article in English | Web of Science | ID: covidwho-2198728

ABSTRACT

IntroductionThe occurrence of oral candidiasis (OC) is expected in patients with COVID-19, especially those with moderate to severe forms of infection who are hospitalized and may be on long-term use of broad-spectrum antibiotics or prolonged corticosteroid therapy. We aimed to characterize clinical conditions, the prevalence profile of Candida species, and outcomes of COVID-19 patients with OC. MethodsIn this observational study, oral samples were obtained from COVID-19 patients suspected of OC admitted to Razi teaching hospital. Patients with OC were monitored daily until discharge from the hospital. Species identification was performed by a two-step multiplex assay named YEAST PLEX, which identifies 17 clinically important uncommon to common yeast strains. ResultsAmong the 4133 patients admitted with COVID-19, 120 (2.90%) suffered from OC. The onset of signs and symptoms of OC in patients was, on average (2.92 +/- 3.596 days) with a range (of 1-29 days). The most common OC presentation was white or yellow macules on the buccal surface or the tongue. In (39.16%) of patients suffering from OC multiple Candida strains (with two or more Candida spp.) were identified. The most common Candida species were C. albicans (60.57%), followed by C. glabrata (17.14%), C. tropicalis (11.42%), C. kefyr (10.83%) and C. krusei (3.42%). Notably, OC caused by multiple Candida strains was more predominant in patients under corticosteroid therapy (P <0.0001), broad-spectrum antibiotics therapy (P = 0.028), and those who used nasal corticosteroid spray (P <0.0001). The majority of patients who recovered from OC at the time of discharge were patients with OC by single Candida species (P = 0.049). DiscussionUse of corticosteroids and antimicrobial therapy in COVID-19 patients increases risk of OC by multiple Candida strains.

2.
Journal of the Royal College of Physicians of Edinburgh ; 52(4):281, 2022.
Article in English | EMBASE | ID: covidwho-2195271
3.
Open Forum Infectious Diseases ; 9(Supplement 2):S226, 2022.
Article in English | EMBASE | ID: covidwho-2189639

ABSTRACT

Background. Invasive fungal diseases (IFD) have been described in patients (pts) with severe coronavirus disease 2019 (COVID), albeit with geographic variability in rates. Methods. We performed a retrospective study to determine rates of & risk factors for IFD occurring within 30 days (d) of COVID diagnosis (dx) in adults requiring critical care for severe COVID between 5/11/20 & 2/7/21. Mortality was assessed at 90 d following COVID dx and at 84 d after IFD dx, if applicable. ECMM/ISHAM criteria were used for COVID-associated pulmonary aspergillosis (CAPA) and EORTC/ MSGERC criteria were used for other IFD and treatment response. Results. 218 pts were included;median age was 62 (19 - 91) & 63% were men. Underlying conditions included solid organ transplant (Tx) (16;7%), allogenic stem cell Tx (3;1%), malignancy (21;10%), & exposure to either high-dose steroids (HDS) (11;5%) or T- or B-cell suppressants (29;13%) within 90 d prior to COVID dx. 209 (96%) pts had respiratory failure & 127 (58%) required mechanical ventilation. 15 (7%) required extracorporeal membrane oxygenation. COVID treatment consisted of corticosteroids in 205 (96%) & tocilizumab in 10 (5%). 12 (6%) pts developed IFD. 6 pts had CAPA (2 probable, 4 possible);50% were men, median age 64.5 (48 - 83). Mean time to CAPA dx from COVID dx was 17 d (+/- 14d). All pts had received corticosteroids for COVID but only 1 pt received > 30d of HDS by the time of IFD dx. Mortality at 84 d from CAPA dx was 67%. 5 (2%) pts had central venous catheter associated candidemia;80% were men & median age 61 (55 - 77). Mean time from COVID to candidemia dx was 29 d (+/-12 d). All pts with Candida infection had received steroids for COVID. Mortality at 84 d from candidemia dx was 60%. A 35-year-old man with prolonged exposure to HDS had Paecilomyces pneumonia;he was alive at 84 d after IFD dx. No cases of mucormycosis were identified. All-cause mortality in the entire cohort was 38% at 90 d after COVID dx. Mortality among pts who developed IFD was 58% at the same time point. Conclusion. Rates of IFD in pts with severe COVID were low and most pts with IFD after COVID had CAPA or catheter-associated candidemia. All but one pt with CAPA had no risk factors for IFD. In pts with severe COVID, mortality was higher among pts who developed IFD than those who did not.

4.
Medical Mycology ; 60(Supplement 1):71, 2022.
Article in English | EMBASE | ID: covidwho-2189359

ABSTRACT

Objectives: The role of Candida in sputum culture is unclear and is generally not treated when present in sputum samples. The objective of this study is to describe the clinical findings of patients with Candida spp. in sputum and their antifungal susceptibility pattern to know the local epidemiology of antifungal resistance. Method(s): Patients with respiratory symptoms attending the tertiary care hospital during the study period of 6 months from June 2021 to December 2021. A total of 23 sputum samples were processed in the microbiology laboratory. Samples were processed following conventional mycological procedures including direct microscopy (visualization of budding yeast cell on grams stain), growth on sabouraud dextrose agar, Germ tube test, and CHROMagar. The isolates were identified by rapid identification (ID) of yeast and yeast-like organisms in the BD PhoenixTM Automated Microbiology System. Antifungal Susceptibility Testing (AFST) was carried outby disk diffusion susceptibility testing, Zone interpretation criteria as per M44/A2 protocol of CLSI were used.Antifungal used were amphotericin B (20 mcg), itraconazole (10 mcg), fluconazole (25 mcg), and voriconazole (1 mcg). Results of tests done on 23 isolates were collated and analyzed retrospectively. Clinical pr ofile of the patients was taken retrospectively from record section and analyzed. Result(s): Of the 23 patients, most common presentation was fever followed by cough and dyspnea.A total of 34% patients were receiving some form of steroid (injectable or inhalational). Only 2 patients were COVID positive by RT-PCR and 7 (30%) patients had some radiological findings like consolidation, emphysematous changes, etc. Immunodeficiency condition was seen in 4 (17%) patients like tuberculosis and diabetes mellitus. Of the 23 samples, C. albicans showed prevalence of 91% as compared with C. tropicalis (5%) and C. glabrata (4.8%). AFST showed Candida spp. was found to be mostly sensitive to voriconazole and fluconazole. Resistance to amphotericin B was seen in most Candida spp. Itraconazole was not susceptible to even one isolate only 4 samples were intermediate (Fig. 1). Conclusion(s): Infections with Candida spp. are usually of low virulence and are associated with a few well-defined risk factors as immunocompromised state, malignancy, and steroid therapy. Understanding these risk factors, identifying the species with changing trends in antifungal resistance, instituting infection control practices to reduce morbidity and mortality in critical care areas can improve outcomes. Surveillance of the rates of Candida infection in critical areas, reporting of outbreaks and continuous monitoring of an-tifungal susceptibility patterns will help in choosing the best therapeutic management of complicated cases. Comparison of trends in infection rates amongst hospitals between various Indian cities and their resistance patterns can reveal vital informa-tion regarding the breakdown of infection control measures. Most Candida infections are of low virulence and only become significant in the vulnerable critical care areas. With the rise in prevalence of inherently azole-resistant species and rising use of echinocandins in ICUs, identifying risk factors and controlling the infection early can improve patient outcomes.

5.
European Journal of Molecular and Clinical Medicine ; 9(7):2551-2558, 2022.
Article in English | EMBASE | ID: covidwho-2169658

ABSTRACT

Candida Auris is an emerging multi-drug-resistant fungus with catastrophic consequences. It is rapidly spreading worldwide in healthcare settings and immunocompromised patients are much at risk. Large outbreaks have been reported worldwide and this phenomenon is mainly associated with the increasing rate of invasive procedures, extensive use of broad-spectrum antimicrobials, and more frequent immunocompromised status of critically ill patients. High mortality rates have been associated with therapeutic failure mainly related to Azole Resistance. Difficulty in microbiological identification, high virulence, multi-drug resistance profile, and rapid global spread with several reported outbreaks make C. Auris as one of the serious emerging pathogens that physicians should be aware of. Our Study retrospectively analyzed the Epidemiology, clinical profile, and sensitivity pattern of Candida Auris infection at Max Super specialty Hospital I.P. Extension, Delhi a tertiary care center in North India. Copyright © 2022 Ubiquity Press. All rights reserved.

6.
Biochimica Clinica ; 46(3):S141, 2022.
Article in English | EMBASE | ID: covidwho-2168941

ABSTRACT

Introduction During long periods of hospitalization, debilitated and immunosuppressed patients are prone to contracting nosocomial fungal infections, such as Candida parapsilosis, which can cause sepsis. Candida parapsilosis, indeed, is able to form firm and persistent biofilms in central venous catheters (CVC) in addition to other medical devices, thus threatening patients undergoing invasive medical procedures [1]. We report a case of Candida parapsilosis sepsis detected in the peripheral blood smear and by the change of the cytograms of the hematology analyzer before to blood culture positivization. Case presentation An 89-year-old woman, positive for the Sars-Cov2 virus, was admitted at the San Donato hospital (Arezzo) for 40 days for Covid symptoms. Laboratory tests show an increase in C reactive protein (10.6 mg/dL), gamma GT (76 U/L), total bilirubin (2.31 mg/dL) and direct (1.46 mg/ dL), creatinine (1.00 mg/dL ) and reduction of glomerular filtrate (50.4 mL/min /1.73 mq). In addition, at the CBC anemia is detected with hemoglobin of 102 (g/L) and thrombocytopenia (32 x 10

7.
Biomolecules ; 12(12) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2199737

ABSTRACT

During the last few decades, the micronutrient zinc has proven to be an important metal ion for a well-functioning immune system, and thus also for a suitable immune defense. Nowadays, it is known that the main cause of zinc deficiency is malnutrition. In particular, vulnerable populations, such as the elderly in Western countries and children in developing countries, are often affected. However, sufficient zinc intake and homeostasis is essential for a healthy life, as it is known that zinc deficiency is associated with a multitude of immune disorders such as metabolic and chronic diseases, as well as infectious diseases such as respiratory infections, malaria, HIV, or tuberculosis. Moreover, the modulation of the proinflammatory immune response and oxidative stress is well described. The anti-inflammatory and antioxidant properties of zinc have been known for a long time, but are not comprehensively researched and understood yet. Therefore, this review highlights the current molecular mechanisms underlying the development of a pro-/ and anti-inflammatory immune response as a result of zinc deficiency and zinc supplementation. Additionally, we emphasize the potential of zinc as a preventive and therapeutic agent, alone or in combination with other strategies, that could ameliorate infectious diseases. Copyright © 2022 by the authors.

8.
Journal of Pharmaceutical Negative Results ; 13:4213-4221, 2022.
Article in English | EMBASE | ID: covidwho-2206778

ABSTRACT

The disastrous Coronavirus Disease outbreak declared as a global pandemic, has become a potential hazard to public health. The second wave of COVID-19 in India has been strongly linked to the rising cases of various fungal infections including mucormycosis, aspergillosis, candidiasis, and mucor septicus. These fungal infections have been a cause for alarm for the general public. The color-coding of the fungal infections is primarily based on the symptoms observed in the infected patients and not based on the color of the fungi itself. For busting the myths behind fungal infections, a comprehensive and deeper understanding of the facts is needed to overcome this challenge. Rapid diagnosis, reversal of underlying predispositions, surgical excision or debridement, and optimal antifungal therapy are some of the crucial factors in combating these fungal infections. This article provides a comparative review of literature on various fungal infections during COVID-19, that have been threatening worldwide, predominantly in India. A well-established databases literature search was conducted. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

9.
HIV Nursing ; 22(2):2928-2931, 2022.
Article in English | Scopus | ID: covidwho-2205820

ABSTRACT

Coronavirus is a devastating global public health disaster in the last years. It affected a large proportion of people around the world. Some of the co-infections associated with the global COVID-19 pandemic are the secondary my cotic infections that following COVID-19 disease. There are genetic and environmental factors that are involved in these infections. In this research, the main goal is to study the my cotic infection of 87 COVID-19 patients of those with comorbidities diseases such as DM, Hypertension, and other chronic disease. Also, to observe the relationship between the my cotic infections and the patients which treated with corticosteroid and broad-spectrum antibiotics. As well as identification of Candida by using an efficient and sensitive molecular method for the Internal transcribed spacer (ITS) gene associated with contagion. Fungal DNA was extracted from patients according to well-established procedures. Then, DNA was amplified by PCR techniques using specific primers for ITS exons. The results of this study indicate a significant association between species of fungi, (P-value = 0.000) and [Chi-square = 54.76). Also, this study shows a significant association between species of Candida, (P-value = 0.000) and [Chi-square = 19.32). As well as the study mentions a significant association between species of fungi and recipient broad-spectrum antibiotics with an increased risk for COVID-19 contagion, (P-value = 0.044). In addition, our outcomes proved no significant association between fungi with smoking, DM, and hypertension, (P-value = 0.143), (P-value = 0.568), and (P-value = 0.070), respectively. Finally, no significant association appeared between fungi with an increased risk for COVID-19 contagion, (P-value = 0.170), [Chi-square = 0.053) about corticosteroid therapy. In conclusion the oral candidiasis was the most frequent infection among COVID-19 patients. However, our findings need more replication in the Arabic countries to confirm these outcomes. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.

10.
Journal of Microbiology, Immunology and Infection ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165600

ABSTRACT

Coronavirus disease-19 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2 that has rapidly evolved into a pandemic to cause over 600 million infections and more than 6.6 million deaths up to Nov 25, 2022. COVID-19 carries a high mortality rate in severe cases. Co-infections and secondary infections with other micro-organisms, such as bacterial and fungus, further increases the mortality and complicates the diagnosis and management of COVID-19. The current guideline provides guidance to physicians for the management and treatment of patients with COVID-19 associated bacterial and fungal infections, including COVID-19 associated bacterial infections (CABI), pulmonary aspergillosis (CAPA), candidiasis (CAC) and mucormycosis (CAM). Recommendations were drafted by the 6th Guidelines Recommendations for Evidence-based Antimicrobial agents use Taiwan (GREAT) working group after review of the current evidence, using the grading of recommendations assessment, development, and evaluation (GRADE) methodology. A nationwide expert panel reviewed the recommendations in March 2022, and the guideline was endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline includes the epidemiology, diagnostic methods and treatment recommendations for COVID-19 associated infections. The aim of this guideline is to provide guidance to physicians who are involved in the medical care for patients with COVID-19 during the ongoing COVID-19 pandemic.

11.
NeuroQuantology ; 20(15):6734-6739, 2022.
Article in English | EMBASE | ID: covidwho-2164832

ABSTRACT

Organs such as the mouth, nose and eyes are the gateway for the coronavirus. If favorable conditions for the increase of infection are created in the oral mucosa with a decrease in immunity, the virus binds to the ACE-2 molecule (angiotensin-converting enzyme 2 membrane protein) and affects the epithelium. In the future, if the oral cavity is not protected, not only the mucous membrane of the oral cavity, but also the tissues around the teeth and the throat, as well as petechiae and stomach ulcers, can be observed [1, 2, 6, 7]. The process of development of ulcers in the oral cavity: painful inflammation of the papillae of the tongue (day), then the appearance of an erythematous spot (day), which turns into irregular and asymptomatic ulcers;therefore, many patients may be unaware of an oral ulcer due to the absence of pain (Chaux-Bodard et al., 2020). The burning sensation in the mouth (22.4%) could be due to several causes (eg, candida infection, dry mouth, mouth ulceration, or medications). A viral infection can weaken the immune system, causing secondary infections such as oral thrush. Candidiasis is the most common opportunistic infection in HIV (Nokta, 2008) and has also been reported in Covid-19 (dos Santos et al., 2020). The manifestation of oral lesions in patients with Covid-19 may be related to the direct or indirect effect of SARSCoV-2 on the oral mucosa, hypersensitivity to drugs taken during Covid-19 infection, the patient's susceptibility to the disease itself, or the duration of hospitalization. The SARS-CoV-2 virus infects human cells through angiotensin converting enzyme (ACE-2) receptors, since ACE-2 acts as the primary host cell receptor for this virus [4, 5, 8]. The oral cavity is an open biological system, in which there is a constant balance between pathogenic factors, such as viruses, bacteria, and the body's defenses. However, such an important balance is often attacked, both due to the multiplication and accelerated development of microorganisms and viruses, and due to the weakening of the very factors of general and especially local immune defense [3]. Immunoglobulins and lytic enzymes play an important role in the body's defense system;they are a component of immunity that-provides protection against pathogens (a wide range of bacteria, fungi, viruses), and also participate in the development of inflammation processes, maintenance and regulation of the adaptive immune system. One of the important components of the complex mechanism of innate immunity are neutrophils, when activated by pathogenic or opportunistic microorganisms, a wide range of anti-inflammatory cytokines is secreted. Copyright © 2022, Anka Publishers. All rights reserved.

12.
Indian Journal of Transplantation ; 16(5):S2-S14, 2022.
Article in English | EMBASE | ID: covidwho-2163909

ABSTRACT

Infections are major cause of morbidity and mortality after transplantation. Although many infections are common worldwide, there are differences in various geographic locations. South Asia and India, in particular, has a very active transplant program for kidney and liver transplantation, however, there are no guidelines as how to screen and provide prophylaxis to solid organ transplant (SOT) recipients and donors for both specific infections prevalent in this region along with usual infections. Keeping this in mind, a working group was created comprising transplant physicians, surgeons, and infectious disease specialists from South Asia as well as experts from other countries. This working group developed guidelines based on published evidence, unpublished data from large centers in this region, along with expert opinion. This section of the guidelines deals with pretransplant screening of donors and recipients, which should be useful in dealing with transplants performed in this region for patients belonging to these countries, for those coming for transplantation from other countries, and for programs outside of South Asia who are screening donors and recipients from this region or who have spent significant time in this region. Copyright © 2022 Indian Journal of Transplantation Published by Wolters Kluwer - Medknow.

13.
Mycopathologia ; 2022.
Article in English | PubMed | ID: covidwho-2158125

ABSTRACT

INTRODUCTION: Fungal co-infections are considered an important complication in hospitalized patients with SARS-CoV-2 that can be attributed to disease aggravation, increased mortality, and poor outcomes. This study was conducted to determine the species distribution and antifungal susceptibility patterns of Candida isolates from hospitalized COVID-19 patients in Shiraz, Iran, in addition to associated risk factors and outcomes of co-infections with Candida species. MATERIALS AND METHODS: In this single-center study, a total of 106 hospitalized COVID-19 patients were evaluated for clinical characteristics and outcomes. Species identification was performed by ITS1-5.8S-ITS2 gene sequencing. Antifungal susceptibility testing to fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, amphotericin B, and nystatin was determined according to the M27-A3/S4 CLSI protocol. RESULTS: Candida species were recovered from 48% (51/106) of hospitalized COVID-19 patients. Statistical analysis showed that patients who had heart failure, bacterial co-infection, and were receiving empirical antifungal therapy had a higher risk of developing Candida co-infection. In total, 71 Candida isolates were recovered, of which C. albicans (69%) was the most prevalent isolate. The majority of the Candida isolates were susceptible to all classes of tested antifungal drugs. DISCUSSION: Our results elucidate a high rate of Candida co-infections among hospitalized COVID-19 patients. Comorbidities such as heart failure, HTN, COPD, bacterial infections as well as therapeutic interventions including catheterization, mechanical ventilation, and ICU admission increased the risk of Candida spp. isolation from the bloodstream, respiratory tract and urine samples, which led to a higher in-hospital mortality rate. Additionally, obtained data clarified that empirical antifungal therapy was not as successful as anticipated.

14.
Journal of Pharmaceutical Negative Results ; 13:849-853, 2022.
Article in English | EMBASE | ID: covidwho-2156350

ABSTRACT

The novel coronavirus disease 2019 is highly contagious disorder cause severe illness in form of fever, myalgia, fatigue, altered smell and taste sensation. The oral cavity manifestations has been discovered in Covid 19 patients. Studies shows that SARS-COV -2 affect respiratory track along with other organs those who have Angiotensin coverting enzyme 2 (ACE 2) receptors. ACE 2 Receptors are found in numerous amount in the oral cavity tissue which are more prone for SARS-COV-2 infections. There are various types of oral lesion associated with covid -19 patients such as ulcers in oral cavity, candidiasis, recurrent herpes simplex, geographical tongue, mucositis and petechiae. It affects oral cavity as well as salivary glands. This review article discusses the major neglected clinical entity such as oral cavity lesion in Covid -19 patients. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

15.
Journal of the American Society of Nephrology ; 33:550, 2022.
Article in English | EMBASE | ID: covidwho-2125765

ABSTRACT

Background: Sodium glucose cotransporter2 inhibitors (SGLT2i) demonstrate a cardioprotective effect and are associated with slowing or preventing CKD progression in the native kidney. However, there is limited data in the literature about their use after a kidney transplantation. Method(s): This is an observational retrospective study in a cohort of kidney transplant recipients at Washington University in St. Louis, treated with SGLT2i for diabetes mellitus type 2. Data collection was conducted by chart review. Our primary endpoint was to assess the safety and adverse reactions in this cohort. Our secondary endpoints included assessments of change in weight/BMI, blood pressure, serum creatinine and eGFR, LDL, HDL and hemoglobin A1C every 6 months with a follow up to 2 years. Analysis for change of these parameters from baseline (at the time of start of the medication) was conducted using matched paired t test. Result(s): A total of 36 of kidney transplant recipients were included. The average age of patients was 55.5 +/- 10.4 years. 23 of 36 patients (63.9%) were males. The adverse events reported were congestive heart failure 2/36 (5.6%), AKI 2/36 (5.6%), candidiasis 1/36 (2.8%), and urinary tract infection 1/36 (2.8%). Our results also revealed that two patients died unrelated to medication use (1 patient died after COVID infection and 1 patient died due to septic shock from a foot infection). As shown in table 1 there was no significant change from baseline in weight/BMI, blood pressure, serum creatinine and eGFR, LDL, HDL or hemoglobin A1C at 6, 12, 18 and 24 months. Conclusion(s): Our preliminary data shows that SGLT2i are relatively safe in the kidney transplant population. Larger multicenter studies are needed to determine the efficacy of these drugs in improving renal function, decreasing cardiovascular events and survival post-transplant, as seen in non-transplant recipients.

16.
Curr Fungal Infect Rep ; : 1-11, 2022 Aug 15.
Article in English | MEDLINE | ID: covidwho-2129362

ABSTRACT

Purpose: Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane's Q test and the I2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results: Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I2 = 0%). Conclusion: Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s12281-022-00439-9.

17.
Curr Fungal Infect Rep ; : 1-9, 2022 Oct 20.
Article in English | MEDLINE | ID: covidwho-2075670

ABSTRACT

Purpose of Review: This review summarizes the available Indian data on epidemiology of invasive fungal infections (IFI) in recipients of solid organ transplants (SOT). The epidemiology is further compared with studies from other parts of the world for each SOT type. Recent Findings: The available studies on Indian epidemiology of IFI in SOT are scarce, though the number of SOTs performed in India have increased tremendously in recent years. The limited data from India present a distinct spectrum of infection in transplant recipients with high incidence of mucormycosis. During COVID-19 outbreak, IFI rate increased and renal transplant recipients acquired mucormycosis earlier than previous studies. Summary: Maximum data on IFI was available from renal transplant recipients, wherein mucormycosis was the predominant IFI in Indian patients in contrast to invasive candidiasis in majority countries. The other IFIs had varied spectrum. With the increasing number of SOTs being performed and the already persisting high burden of IFI in India, there is an urgent need of larger prospective studies on epidemiology of IFI in transplant recipients.

18.
Journal of the Scientific Society ; 49(2):106-113, 2022.
Article in English | Web of Science | ID: covidwho-2072002

ABSTRACT

The coronavirus disease 2019 pandemic (COVID-19) has led to considerable hike in hospitalizations for pneumonia with multiorgan disease requiring immediate hospital care, maintenance of oxygen saturation level, and severe cases requiring mechanical ventilation. This opens the window of opportunity to microscopic organisms such as different species of fungus including Candida, Aspergillus, Rhizopus, and Cryptococcus adding other fungi causing opportunistic invasive fungal infections (OIFIs), and other bacteria to cause concurrent infections in COVID-19-diseased patients which on occasion not promptly diagnosed and are mostly diagnosed after death, which get chance due to invasive procedures such as intubation and immunosuppressant drugs which mostly consists of corticosteroids, patient with diabetes mellitus or any other chronic disease causing immunosuppression, patient having a history of chronic obstructive airway disease, development of antibiotic resistance, and vulnerability of pulmonary tissues regarding developing colony for mycotic infections. In this review, we talk over the character of mycotic concurrent infections in aggravation of COVID-19 disease severity and focus on arising trends associated with fungal infections in coronavirus-diseased (COVID-19 diseased) cases. In addition, this review impart the view on the risky component for concurrent mycotic infections in COVID-19 diseased patients who are hospitalized and focuses the possible task of extended immunemodulatory treatments in managing concurrent mycotic infections, comprising COVID-19-associated pulmonary aspergillosis, COVID-19-associated Candidiasis, and mucormycosis. This article restates the demand for prompt detection regarding presumed COVID-19-related systematic mycosis in the health-care settings which could empower fast OIFI diagnosis, treatment, and lowers the mortality rate.

19.
Comb Chem High Throughput Screen ; 2022 Oct 07.
Article in English | MEDLINE | ID: covidwho-2065275

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has a serious threat to human health. Oral candidiasis (OC) may be one of the causes of morbidity in severe COVID-19 patients. However, there is currently no treatment for oral candidiasis and COVID-19 (OC/COVID-19). The purpose of this study was to use text mining and data analysis to investigate the target genes for treatment and explore potential therapeutic drugs for OC/COVID-19. METHODS: We used the text mining tool pubmed2ensembl to detect genes associated with OC, and the dataset GSE164805 was used for the data analysis. Then, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed on the two intersection genes using the Database of Annotation, Visualization and Integrated Discovery (DAVID) platform. The protein-protein interaction (PPI) networks were constructed by STRING software, and gene module analysis was performed using Molecular Complex Detection (MCODE), a plug-in in Cytoscape. The most significant genes were selected as hub genes and their functions and pathways were analyzed using Metascape. We revealed the upstream pathway activity of the hub genes. The drug-gene interaction database (DGIdb) and the traditional Chinese medicines integrated database (TCMID) were used to discover potential drugs for the treatment of OC/COVID-19. RESULTS: The analysis indicated that there were 2869 differentially expressed genes (DEGs) in GSE164805. We identified 161 unique genes associated with oral candidiasis through text mining. A total of 20 intersection genes were identified as the therapeutic targets for OC/COVID-19. Based on the bioinformatics analysis, nine genes (TNF, IL1B, IFNG, CSF2, ELANE, CCL2, MMP9, CXCR4, and IL1A) were identified as hub genes that were mainly enriched in the IL-17 signaling pathway, TNF signaling pathway, AGE-RAGE signaling pathway in diabetic complications and NOD-like receptor signaling pathway. We identified four of the nine genes that target five existing drugs, including BKT140, mavorixafor, sivelestat, canakinumab, and rilonacept. Furthermore, twenty herb ingredients were also screened as potential drugs. CONCLUSION: In this study, TNF, IL1B, IFNG, CSF2, ELANE, CCL2, MMP9, CXCR4, and IL1A were potentially key genes involved in the treatment of OC/COVID-19. Taken together five drugs and twenty herb ingredients were identified as potential therapeutic agents for OC/COVID-19 treatment and management.

20.
Chest ; 162(4):A1776, 2022.
Article in English | EMBASE | ID: covidwho-2060859

ABSTRACT

SESSION TITLE: COVID-19 Case Report Posters 3 SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: The most reported fungal infections in patients with COVID-19 include aspergillosis, invasive candidiasis, and mucormycosis. We hereby present a case of a male who developed acute pulmonary histoplasmosis (APH) after COVID-19 infection. CASE PRESENTATION: 51-year-old male with PMHx of COVID-19 infection 3 weeks ago presenting with worsening shortness of breath. Patient had a complicated hospital course with COVID-19 treated with high doses of methylprednisolone. Patient was local to Arizona and lived on a ranch with livestock. CT chest suggestive of multilobar pneumonia and bilateral pleural effusions (Image 1). Coccidiomycosis serology came back negative. Urinary Histoplasma galactomannan antigen came back positive. The diagnosis of APH after COVID-19 infection was established. Patient was started on voriconazole. His symptoms significantly improved. Patient was discharged to skilled nursing facility with outpatient infectious disease follow-up. DISCUSSION: The current literature on APH in the setting of COVID-19 infection is limited. The few proposed mechanisms are: 1. Liberal use of high dose steroids in COVID-19 leading to reactivation of latent H. Capsulatum. 2. Systemic inflammation in COVID-19 causes interstitial lung damage permitting conidia to proliferate leading to acute infection. The Histoplasma urine antigen test is highly sensitive in the diagnosis of APH, especially in immunocompromised patients like our patient. With this case we would like to increase awareness of the possibility of rare fungal infections like APH in patients with COVID-19, as timely diagnosis and appropriate management can lead to improved outcomes. CONCLUSIONS: Rare fungal infections following COVID-19 have been documented and timely diagnosis and management are imperative to improve patient outcomes. Reference #1: Macedo, Priscila M, et al. APH following COVID-19. Case Report J.Fungi 2021 DISCLOSURES: No relevant relationships by Ali Raja no disclosure on file for Yamin Saddouk;No relevant relationships by Parita Soni No relevant relationships by Lyndie Wilkins Parker

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