COVID-19 associated mold infections: Review of COVID-19 associated pulmonary aspergillosis and mucormycosis |
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Affiliation: | 1. Division of Infectious Disease, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;2. School of Internal Medicine, National Yang Ming Chao Tung University, Taipei, Taiwan;3. Division of Infectious Diseases, Department of Medicine, MacKay Memorial Hospital, Taipei, Taiwan;4. MacKay Medical College, New Taipei City, Taiwan;5. Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan;6. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan;7. Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;8. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;9. School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;10. M.Sc. Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;11. Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan;12. Department of Pediatrics, National Taiwan University Children''s Hospital, Taipei, Taiwan;13. Division of Infectious Diseases, Department of Internal Medicine, Shin Kong Wu Ho- Su Memorial Hospital, Taipei, Taiwan;14. Department of Infectious Diseases, Chi-Mei Medical Center, Tainan, Taiwan;15. Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan;p. Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan;q. College of Medicine, National Cheng Kung University, Tainan, Taiwan;r. Department of Pediatrics, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan;s. MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan;t. Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan |
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Abstract: | COVID-19-associated mold infection (CAMI) is defined as development of mold infections in COVID-19 patients. Co-pathogenesis of viral and fungal infections include the disruption of tissue barrier following SARS CoV-2 infection with the damage in the alveolar space, respiratory epithelium and endothelium injury and overwhelming inflammation and immune dysregulation during severe COVID-19. Other predisposing risk factors permissive to fungal infections during COVID-19 include the administration of immune modulators such as corticosteroids and IL-6 antagonist. COVID-19-associated pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) is increasingly reported during the COVID-19 pandemic. CAPA usually developed within the first month of COVID infection, and CAM frequently arose 10–15 days post diagnosis of COVID-19. Diagnosis is challenging and often indistinguishable during the cytokine storm in COVID-19, and several diagnostic criteria have been proposed. Development of CAPA and CAM is associated with a high mortality despiteappropriate anti-mold therapy. Both isavuconazole and amphotericin B can be used for treatment of CAPA and CAM; voriconazole is the primary agent for CAPA and posaconazole is an alternative for CAM. Aggressive surgery is recommended for CAM to improve patient survival. A high index of suspicion and timely and appropriate treatment is crucial to improve patient outcome. |
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Keywords: | Aspergillosis Mucormycosis COVID-19 CAPA CAM ACE2" },{" #name" :" keyword" ," $" :{" id" :" pc_4HPTVP8tPl" }," $$" :[{" #name" :" text" ," _" :" Angiotensin-converting enzyme 2 BALF" },{" #name" :" keyword" ," $" :{" id" :" pc_PkqUzFQwI7" }," $$" :[{" #name" :" text" ," _" :" Broncheoalveolar lavage fluid CAM" },{" #name" :" keyword" ," $" :{" id" :" pc_y463skxhQo" }," $$" :[{" #name" :" text" ," _" :" COVID-19 associated mucormycosis CAPA" },{" #name" :" keyword" ," $" :{" id" :" pc_8YMKgL6Z9d" }," $$" :[{" #name" :" text" ," _" :" COVID-19 associated pulmonary aspergillosis GM" },{" #name" :" keyword" ," $" :{" id" :" pc_gUf6ETx299" }," $$" :[{" #name" :" text" ," _" :" Galactomannan non-BALF" },{" #name" :" keyword" ," $" :{" id" :" pc_IVCSgXMkMI" }," $$" :[{" #name" :" text" ," _" :" Fluid obtained from lower respiratory tract by non-BAL procedure non-CAPA" },{" #name" :" keyword" ," $" :{" id" :" pc_U466aMlohN" }," $$" :[{" #name" :" text" ," _" :" Patients with SARS-CoV-2 virus infection who did not develop CAPA |
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