A Comprehensive Study of the Global COVID-19 Pandemic and Fungal Co-Infections: A Review

Naghmeh Bahrami; Mohammad Bayat; Zahra  Surani; Sadegh  Shirian; Mohammad   Shahverdi; Rosa  Karimi; Seyedeh Narges  Tabatabaee; Alireza  Abolfathi; Hannaneh  Yousefi-Koma; Shadi  Shafaghi; Mahdi  Ahmadinia; Abdolreza  Mohamadnia

doi:10.18502/jcr.v12i3.20622

Naghmeh Bahrami Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Bayat Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Zahra Surani Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran.
Sadegh Shirian Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran.
Mohammad Shahverdi Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran.
Rosa Karimi Department of Microbiology, School of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran.
Seyedeh Narges Tabatabaee Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Alireza Abolfathi Islamic Azad University, Tehran, Iran.
Hannaneh Yousefi-Koma Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shadi Shafaghi Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mahdi Ahmadinia Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abdolreza Mohamadnia Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jcr.v12i3.20622

Keywords: Covid-19; Sars-cov-2; Fungal co-infection; Aspergillosis; Mucormycosis; Candidiasis.

Abstract

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-19), which has resulted in high death tolls around the world and a significant health burden. The purpose of this study is to bring attention to the early diagnosis and treatment of fungal diseases in coronavirus disease 2019 (COVID-19) patients.

Materials and Methods: We searched peer-reviewed articles, reviews, surveillance reports, and clinical studies published from January 2020 to December 2023 using databases including PubMed, Scopus, and Web of Science.

Results: Severely ill COVID-19 patients are at high risk for life-threatening fungal co-infections. The most prevalent is pulmonary aspergillosis, affecting up to a third of ICU patients, largely driven by corticosteroid use. Candidiasis is also common with prolonged ICU stays. Diagnosis is challenging, and treatment requires specific antifungals.

Conclusion: Fungal co-infections increase COVID-19 mortality. Manage with early diagnosis, targeted antifungals, and risk factor control. Global focus on awareness, diagnostics, and antifungal stewardship is crucial.