Fungi worsen Covid mortality in severe forms – The HuffPost

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HEALTH – Infection with fungi can worsen respiratory distress in patients with severe disease. Covid-19, going so far as to double their rate of mortality, according to a study of 576 intensive care patients.

This study, called MYCOVID and published in the scientific journal The Lancet Respiratory Medicine, also found a high number of episodes of proven or probable invasive fungal infections (22.4%), such as invasive aspergillosis.

“Invasive aspergillosis is a disease that is well known in the hospital in very immunocompromised patients. In recent years, we have seen it appear in people who had severe influenza with acute respiratory distress syndrome (ARDS) ”, explained to AFP Professor Jean-Pierre Gangneux, head of the parasitology and mycology laboratory of Rennes University Hospital and study coordinator.

At the beginning of the Covid-19 epidemic, “When we saw the clinical pictures of the Covid, which looked like severe flu, we said to ourselves that we absolutely had to put in place surveillance”, he added.

″ Major event ”

Started in April 2020, MYCOVID was initially to follow 250 patients from entry to discharge from intensive care. The study finally exceeded 500 patients in 18 hospitals across France. “The biggest world series” in the field, according to Professor Gangneux.

For patients with a severe form of Covid and also infected with invasive aspergillosis, the study shows a doubling of mortality (61.8% against 32.1%). “This co-infection with a fungus is a major event that worsens the aftermath of a serious Covid infection”, underlines the researcher. Proven or probable invasive pulmonary aspergillosis (14.9%) and candidemia (6.2%) appear to be the two most frequent infections.

“Aspergillus is ubiquitous: we breathe three or four spores per cubic meter of air. In normal situations, we eliminate them ”, specifies the researcher. In the context of Covid patients with acute respiratory distress, the researchers identified three risk factors for the emergence of the infection: age (over 62 years), two anti-Covid drugs (dexamethasone associated with anti-IL6R) and mechanical ventilation for more than 15 days.

“There are aggravating factors linked to the anti-Covid treatment”, explained the researcher. “For a large majority of people, these are effective treatments, which can treat the underlying disease. But these treatments sometimes promote the emergence of infections, ”explained Professor Gangneux.

“The high prevalence and mortality of invasive aspergillosis and candidaemia revealed by the MYCOVID study underline the urgent need to establish an index of suspicion and to implement an active surveillance of invasive fungal infections in patients with an severe form of Covid-19 in intensive care ”, adds to West France Dr Marie-Elisabeth Bougnoux, Necker-Enfants Malades Hospital AP-HP / University of Paris / Fungal Biology and Pathogenicity Unit at the Institut Pasteur.

More studies will need to be done to determine whether early antifungal treatment or prophylaxis is needed, the researchers say.

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