Title : Immunosuppression in COVID-19 Patients and Emerging Fungal Infections: Vaccines, Diagnosis and Strategies to Treat Comorbidities
Abstract:
The incidence of fungal infections, called mycosis, has dramatically increased in COVID-19 patients with predisposing factors. COVID-19, not over and still circulating worldwide, is a respiratory illness caused by strains of coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). It is a highly transmissible, contagious airborne, positive-sense single-stranded RNA virus. This disease was first of all reported in December 2019 from the city of Wuhan, China, and was declared as a pandemic on 11 March, 2020 by WHO and continued till May 2023. It has been ranked as the 5th deadliest pandemic or epidemic in the human history that caused over 7 million deaths of the 777million people affected globally, as of 22 December 2024. The vaccination is widely credited for its role in reducing the transmission of infection, disease severity, creating herd immunity and saving millions of lives from COVID-19. The COVID-19 vaccines that were granted emergency use authorization (EUA)
by WHO during 2020-2021 include: Pfizer/BioNTech vaccine, COVAXIN Bharat Biotech, Covishield Oxford/AstraZeneca, Spikevax Moderna vaccine and Janssen Johnson & Johnson. Globally, 67% of the total population has been vaccinated with a complete primary series of a COVID-19 vaccine, creating herd immunity. As of 12 August 2024, 13.72 billion doses of vaccines have been administered worldwide. If vaccines could not have been developed in short duration of time and got emergency approval for usage from the WHO, there
would have been billions of deaths and very few of us would have been here to see the new day. COVID-19 has increased human fungal infections, because of its effect on the immune system leading to severe illness and death. Body's defences against fungal pathogens also lower due to COVID-19 treatments like steroids and other
antiviral drugs. Comorbidities or fungal coinfections i.e., patients having both a fungal infection and COVID-19 at the same time, might have been missed or misdiagnosed resulting to death of several thousand patients. Symptoms of certain fungal infections (e.g., fever, cough and shortness of breath) are similar to COVID-19. For proper, effective and safe treatment of patients suffering due to comorbidities, laboratory diagnosis is of utmost importance to know whether a patient is suffering from a virus, a fungus, or a bacterium. The most common
COVID-19-associated mycoses reported are: aspergillosis, invasive candidiasis (due to Candida auris and C. albicans), pulmonary mucormycosis (black fungus disease due to mucoraceous molds), cryptococcosis, and fungal pneumonias (histoplasmosis, coccidioidomycosis, blastomycosis). The need of the hour is to lay emphasis in identifying potential fungal coinfection with COVID-19 and other microbial infections that can reduce diagnosis and treatment delays for preventing severe illness and deaths from such infections.
