Abstract

Coronavirus disease 2019 (COVID-19) can become complicated by secondary invasive fungal infections (IFIs), stemming primarily from severe lung damage and immunologic deficits associated with the virus or immunomodulatory therapy. Other risk factors include poorly controlled diabetes, structural lung disease and/or other comorbidities, and fungal colonization. Opportunistic IFI following severe respiratory viral illness has been increasingly recognized, most notably with severe influenza. There have been many reports of fungal infections associated with COVID-19, initially predominated by pulmonary aspergillosis, but with recent emergence of mucormycosis, candidiasis, and endemic mycoses. These infections can be challenging to diagnose and are associated with poor outcomes. The reported incidence of IFI has varied, often related to heterogeneity in patient populations, surveillance protocols, and definitions used for classification of fungal infections. Herein, we review IFI complicating COVID-19 and address knowledge gaps related to epidemiology, diagnosis, and management of COVID-19–associated fungal infections.

Details

Title
Coronavirus Disease 2019–Associated Invasive Fungal Infection
Author
Baddley, John W 1   VIAFID ORCID Logo  ; Thompson, George R, III 2 ; Chen, Sharon C -A 3 ; P Lewis White 4 ; Johnson, Melissa D 5 ; M Hong Nguyen 6 ; Schwartz, Ilan S 7 ; Spec, Andrej 8 ; Ostrosky-Zeichner, Luis 9   VIAFID ORCID Logo  ; Jackson, Brendan R 10 ; Patterson, Thomas F 11 ; Pappas, Peter G 12 

1  Department of Medicine, University of Maryland School of Medicine and Baltimore Veterans Affairs Medical Center, Baltimore, Maryland, USA 
2  Department of Internal Medicine, Division of Infectious Diseases and Department of Medical Microbiology and Immunology, University of California, Davis Medical Center, Sacramento, California, USA 
3  Centre for Infectious Diseases and Microbiology, Westmead Hospital and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia 
4  Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, United Kingdom 
5  Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA 
6  Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA 
7  Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada 
8  Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri, USA 
9  Division of Infectious Diseases, McGovern Medical School, Houston, Texas, USA 
10  Centers for Disease Control and Prevention, Atlanta, Georgia, USA 
11  University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; South Texas Veterans Health Care System, San Antonio, Texas, USA 
12  Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA 
Publication year
2021
Publication date
Dec 2021
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/ofid/ofab510
ProQuest document ID
3170956317
Copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.