COVID-19 patients could be more susceptible to fungal infections, according to researchers from Imperial College London. The researchers say that there has been reported evidence that patients with COVID-19 may be more at risk of lung infections caused by breathing in mold.
The researchers warn that the condition, COVID-19 associated pulmonary aspergillosis (CAPA), has been reported in up to an alarming 20-35 percent of mechanically ventilated patients, in European studies.
Writing in the European Respiratory Journal, the researchers argue that critically ill patients with COVID-19 that are not recovering as expected should be screened for CAPA. The researchers, from Imperial’s MRC Centre for Global Infectious Disease Analysis, the MRC Centre for Molecular Bacteriology and Infection, and other institutions, say that recent findings indicate that drugs used to treat COVID-19 such the corticosteroid dexamethasone may contribute to the risk of CAPA.
Corticosteroid use has been reported in hospitalized patients with COVID-19 and may further contribute to the risk of CAPA. Dexamethasone was found in a recent trial to reduce mortality in ventilated COVID-19 patients by a third but also may increase the risk of patients getting CAPA. The researchers note that some immunomodulatory drugs which are currently undergoing trials for COVID-19, may also predispose patients to CAPA.
Screening for CAPA usually involves using a combination of CT chest imaging and antigen and blood tests. The researchers state that the gold standard for diagnosing CAPA should include a bronchoscopy, where a small camera is passed through the throat to inspect the lungs but diagnosis of CAPA is hampered as the procedure is high risk for aerosolization of COVID-19
However, the impact of overburdened critical care services may increase the risks associated with CAPA if this potentially lethal infection remains undiagnosed.
