COVID-19患者的真菌合并感染:我们应该关注吗?

IF 1.5 4区 生物学 Q4 MYCOLOGY
Javier Pemán , Alba Ruiz-Gaitán , Carolina García-Vidal , Miguel Salavert , Paula Ramírez , Francesc Puchades , Marta García-Hita , Ana Alastruey-Izquierdo , Guillermo Quindós
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引用次数: 124

摘要

危重患者促炎因子(IL-1、IL-2、IL-6、肿瘤坏死因子α)和抗炎因子(IL-4、IL-10)水平较高,CD4干扰素γ表达较低,CD4和CD8细胞较少。这种严重的临床情况增加了严重真菌感染的风险,如侵袭性肺曲霉病、侵袭性念珠菌病或耶氏肺囊虫肺炎。然而,很少有研究调查真菌在这一人群中的共感染。我们描述了真菌合并感染的最新发表报告和我们在三家西班牙医院的个人经验。我们可以得出结论,尽管SARS-CoV-2在许多患者中引起了严重的疾病,但侵袭性真菌病的稀少可能是由于这些患者由于气溶胶产生的高风险而很少进行支气管镜检查和尸检。然而,在临床相关标本中存在真菌标记物,除了念珠菌在支气管肺定植外,应建议早期实施抗真菌治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fungal co-infection in COVID-19 patients: Should we be concerned?

Critically ill COVID-19 patients have higher pro-inflammatory (IL-1, IL-2, IL-6, tumor necrosis alpha) and anti-inflammatory (IL-4, IL-10) cytokine levels, less CD4 interferon-gamma expression, and fewer CD4 and CD8 cells. This severe clinical situation increases the risk of serious fungal infections, such as invasive pulmonary aspergillosis, invasive candidiasis or Pneumocystis jirovecii pneumonia. However, few studies have investigated fungal coinfections in this population. We describe an update on published reports on fungal coinfections and our personal experience in three Spanish hospitals. We can conclude that despite the serious disease caused by SARS-CoV-2 in many patients, the scarcity of invasive mycoses is probably due to the few bronchoscopies and necropsies performed in these patients because of the high risk in aerosol generation. However, the presence of fungal markers in clinically relevant specimens, with the exception of bronchopulmonary colonization by Candida, should make it advisable to early implement antifungal therapy.

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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
17
审稿时长
81 days
期刊介绍: Revista Iberoamericana de Micología (Ibero-American Journal of Mycology) is the official journal of the Asociación Española de Micología, Asociación Venezolana de Micología and Asociación Argentina de Micología (The Spanish, Venezuelan, and Argentinian Mycology Associations). The Journal gives priority to publishing articles on studies associated with fungi and their pathogenic action on humans and animals, as well as any scientific studies on any aspect of mycology. The Journal also publishes, in Spanish and in English, original articles, reviews, mycology forums, editorials, special articles, notes, and letters to the editor, that have previously gone through a scientific peer review process.
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