COVID-19-Associated Candidiasis (CAC): An Underestimated Complication in the Absence of Immunological Predispositions?

Journal of Fungi

卷:6

Amir Arastehfar¹  DavidS. Perlin¹  Martin Hoenigl²  MihaiG. Netea³  M.Hong Nguyen⁴  MohammadTaghi Hedayati⁵  Agostinho Carvalho⁶ 

[1] Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA;

[2] Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA 92093, USA;

[3] Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Centre, 6500HB Nijmegen, The Netherlands;

[4] Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA;

[5] Invasive Fungi Research Center, Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran;

[6] Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal;

关键词: candidemia;    candiduria;    oral candidiasis;    mycobiome;   

DOI  :  10.3390/jof6040211

来源: DOAJ

【 摘 要 】

The recent global pandemic of COVID-19 has predisposed a relatively high number of patients to acute respiratory distress syndrome (ARDS), which carries a risk of developing super-infections. Candida species are major constituents of the human mycobiome and the main cause of invasive fungal infections, with a high mortality rate. Invasive yeast infections (IYIs) are increasingly recognized as s complication of severe COVID-19. Despite the marked immune dysregulation in COVID-19, no prominent defects have been reported in immune cells that are critically required for immunity to Candida. This suggests that relevant clinical factors, including prolonged ICU stays, central venous catheters, and broad-spectrum antibiotic use, may be key factors causing COVID-19 patients to develop IYIs. Although data on the comparative performance of diagnostic tools are often lacking in COVID-19 patients, a combination of serological and molecular techniques may present a promising option for the identification of IYIs. Clinical awareness and screening are needed, as IYIs are difficult to diagnose, particularly in the setting of severe COVID-19. Echinocandins and azoles are the primary antifungal used to treat IYIs, yet the therapeutic failures exerted by multidrug-resistant Candida spp. such as C. auris and C. glabrata call for the development of new antifungal drugs with novel mechanisms of action.

【 授权许可】

Unknown