Severe COVID-19 disease is associated with an increase in pro-inflammatory markers, such as IL-1, IL-6, and tumor necrosis alpha, less CD4 interferon-gamma expression, and fewer CD4 and CD8 cells, which increase the susceptibility to bacterial and fungal infections. One such opportunistic fungal infection is mucormycosis. Initially, it was debated whether a person taking immunosuppressants, such as corticosteroids, and monoclonal antibodies will be at higher risk for COVID-19 or whether the immunosuppresive state would cause a more severe COVID-19 disease. However, immunosuppressants are currently continued unless the patients are at greater risk of severe COVID-19 infection or are on high-dose corticosteroids therapy. As understood so far, COVID-19 infection may induce significant and persistent lymphopenia, which in turn increases the risk of opportunistic infections. It is also noted that 85% of the COVID-19 patients’ laboratory findings showed lymphopenia. This means that patients with severe COVID-19 have markedly lower absolute number of T lymphocytes, CD4+T and CD8+ T cells and, since the lymphocytes play a major role in maintaining the immune homeostasis, the patients with COVID-19 are highly susceptible to fungal co-infections. This report is intended to raise awareness of the importance of early detection and treatment of mucormycosis and other fungal diseases, such as candidiasis, SARS-CoV-2-associated pulmonary aspergillosis, pneumocystis pneumonia and cryptococcal disease, in COVID-19 patients, to reduce the risk of mortality.
【저자키워드】 COVID-19, SARS-CoV-2, Coinfection, Mucormycosis, aspergillosis, Candida auris, Fungal infection, Cryptococcus neoformans, pneumocystis pneumonia, 【초록키워드】 Treatment, Necrosis, Corticosteroids, Diseases, Mortality, severe COVID-19, Pneumonia, IL-6, susceptibility, monoclonal antibody, risk, CD4, CD8, immunosuppressants, Laboratory, COVID-19 disease, lymphopenia, lymphocyte, COVID-19 infection, cells, Patient, Immune homeostasis, Alpha, T lymphocytes, fungal infections, expression, IL-1, fungal, severe COVID-19 disease, CD8+ T cell, COVID-19 patients, Immunosuppressant, opportunistic Infections, Bacterial, High-dose, Severe COVID-19 Infection, higher risk, Cryptococcal disease, pro-inflammatory, susceptible, corticosteroids therapy, raise, greater, the patient, increase, less, increase in, induce, reduce, turn, Initially, with COVID-19, 【제목키워드】 Mortality, Co-infection,