Fungal diseases as a threatening side effect of corona infection – healing practice

Fungal infections associated with COVID-19: Clinical risk factors identified

fungal infections are a major challenge for medicine. Treatment options for life-threatening infections are extremely limited. Corona exacerbates the problem: researchers have linked to COVID-19[feminine] identified three important fungal infections.

Corona can have long-term consequences. In addition to Long-COVID, there is another acute and highly threatening side effect of SARS-CoV-2 infection: fungal diseases. Researchers have now identified important immunological mechanisms and clinical risk factors for fungal infections associated with COVID-19. Their results were published in the journal “Natural microbiology“published.

Three important fungal infections identified in relation to Corona

As in a Message from the Medical University (Med Uni) Graz, three important fungal infections have been identified in relation to COVID-19:

Pulmonary aspergillosis associated with COVID-19 (ACAP), candidiasis associated with COVID-19 (CAC) and especially with the emergence of the delta variant in India, the mucormycosis associated with COVID-19 (CAM).

Many studies have addressed regional phenomena and aspects, but a look at the global development of these diseases associated with COVID-19 is so far lacking.

Independent disease forms?

One of the main motives for the ongoing international study with the participation of Med Uni Graz was to find out to what extent fungal diseases are actually related to COVID-19 and by COVID-19 partially are.

Noisy Martin Hoenigl from the Clinical Department of Infectious Diseases of Med Uni Graz was a fundamental question and motivation for their study, “to clarify whether CAPA and CAM represent independent forms of disease that are also caused by specific immunological mechanisms and interactions, or whether they are purely the result of clinical risk factors in the intensive care unit are” and therefore affect people with COVID-19 and non-COVID-19 equally.

In fact, CAPA and CAM have specific immunological links with COVID-19 infection, CAC, i.e. the candidiasisbut this is largely absent.

COVID-19 treatment as a risk factor

The mushroom that aspergillosis causes, according to the expert, finds a perfect basis to grow in lung tissue through tissue destruction in the context of COVID-19 infection and the resulting high cytokine release.

According to the researcher, in particular, the suppression of a specific immunological mechanism that predisposes Immune response to type 1 interferonwhich occurs in severe cases due to COVID-19, these patients develop CAPA.

“Of course, COVID-19 therapy in the intensive care unit with dexamethasone and tocilizumab also plays an important role. risk factor.”

In Western countries, CAMs are rather rare

CAM shows a differentiated and also more complex picture. Although mucormycosis occurs worldwide, it is more common in IndiaCAM (also known as the “Black Fungus Pandemic” in the media) gained notoriety during the delta wave in India.

Diseases such as untreated diabetes may make it easier for the pathogens responsible for SARS-CoV-2 and CAM to overcome the nasal mucosa enter the body.

In India, it mainly led to the so-called rhino-orbital or rhino-orbital brain mucormycosis: a fungal disease that can destroy facial structures around the eyes and nose and ultimately the brain.

In Western and affluent countries, CAM occurs rarely and when it does, it tends to present in the pulmonary or disseminated form.

Especially in medical institutions

Unlike CAPA and CAC, candidiasis does not have a direct correlation with SARS-CoV-2 infection. In fact, it is an infection that in medical institutions occurs. Important factors here are overcrowded intensive care units, central venous catheters, artificial nutrition and longer stays in an intensive care unit.

High mortality

Unfortunately, fungal infections in the setting of COVID-19 disease come with a strong mortality on. Depending on how quickly the infection is detected, 50-80% of those infected die. Survivors of rhino-orbital cerebral mucormycosis suffer from lifelong facial disfigurement and often lose one or both eyes as a result of the necessary surgery.

No difference yet in treatment options

Currently they differ treatment options in COVID-19-associated disease are not yet different from their COVID-19-independent counterparts, but new classes of antifungals research that should show better results, as well as specific interventions that target the immunological mechanisms that predispose people to COVID-19, such as the development of CAPA. (ad)