Objective: to describe a single-center experience of Pneumocystis jirovecii pneumonia (PJP) in non-HIV patients recovering from COVID-19. Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital. Results: With the exception of one subject, who experienced an atypical and prolonged course of COVID-19, all the patients developed PJP after the clinical resolution of COVID-19 pneumonia. All but one patient had no pre-existing immunosuppressive conditions or other risk factors for PJP development at COVID-19 diagnosis. Nonetheless, following the course of COVID-19 infection, all the patients fulfilled at least one host factor for PJP; indeed, all the patients had received at least 2 weeks of high-dose steroids and three out of five had a CD4+ cell count <200/mm 3 . Conclusions: The use of corticosteroids for COVID-19 respiratory impairment seems to be the most common risk factor for PJP, together with viral-induced and iatrogenic lymphopenia. The worsening in respiratory function and the characteristic radiological picture during or after COVID-19 pneumonia should raise the suspicion of PJP, even in immunocompetent patients. PJP primary chemoprophylaxis can be considered in selected high-risk COVID-19 patients, but further studies are needed.
【저자키워드】 COVID-19, Corticosteroids, lymphopenia, Invasive fungal infections, Pneumocystis jirovecii, 【초록키워드】 Pneumonia, Respiratory function, risk factor, COVID-19 infection, Patient, COVID-19 diagnosis, characteristic, university, patients, COVID-19 patients, Atypical, steroid, High-dose, subject, worsening, single-center, CD4+, respiratory impairment, cell count, Host, FIVE, radiological, raise, Course, selected, the patient, had no, viral-induced, iatrogenic, immunosuppressive condition, patients with COVID-19, recovering from COVID-19, use of corticosteroid, 【제목키워드】 experience,