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Diagnosis and Treatment of Fungus and Virus Interaction
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Diagnosis and Treatment of Fungus and Virus Interaction

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (1 March 2022) | Viewed by 20532

Special Issue Editors

Dr. Chih-Cheng Lai

E-Mail Website
Guest Editor
Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Taiwan
Interests: fungal diseases; SARS-CoV-2; COVID-19
Special Issues, Collections and Topics in MDPI journals
Dr. Wen-Liang Yu

E-Mail Website
Guest Editor
1. Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
2. Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Interests: influenza; aspergillosis; fungal pathogens; cytomegalovirus

Special Issue Information

Dear Colleagues,

Many viruses are pathogens with a serious impact on human and animal health. They mostly cause enteric or respiratory disease, which can be severe and life threatening, e.g., coronaviruses causing severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), and SARS-CoV-2 causing COVID-19 in humans. Furthermore, post-viral fungal infection has been recognized and has become a hot topic among mycologists and the general public. Next to a role in basic virus replication, the virus–host interplay may create an optimal environment for fungal assembly. This highlights the importance of advancing our knowledge on the replication of viruses and their interactions with fungi. These virus–host interactions are key to viral pathogenesis and will ultimately determine the outcome of fungal infection. It is another important concept that virus and fungus interactions meet a susceptible host for disease development during favorable environmental conditions. The rapid identification of fungal disease through the timely recognition of their symptoms is an effective management practice and may help to control and prevent their spread and progress.

This Special Issue of the Journal of Fungi (MDPI) will focus on the interaction between viruses and fungi—for example, an overview of the vast arena of how viruses are able to cause fungal diseases in a host. Studies covering new epidemiological knowledge, rapid and accurate diagnosis tools, and treatment of virus-associated fungal diseases, including fungal spores and viruses in air, and the impacts that environmental fungi play on viral seasons, animals, and humans will be welcome.

Dr. Chih-Cheng Lai
Dr. Wen-Liang Yu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Aspergillus
  • Coronavirus
  • Cytomegalovirus
  • Influenza
  • Mucormycosis
  • Pneumocystosis
  • Virus-associated fungal diseases

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Published Papers (7 papers)

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Editorial

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3 pages, 177 KiB  
Editorial
Diagnosis and Treatment of Fungus and Virus Interaction
by Chih-Cheng Lai and Wen-Liang Yu
J. Fungi 2022, 8(6), 620; https://doi.org/10.3390/jof8060620 - 10 Jun 2022
Viewed by 1790
Abstract
Many viruses can have a serious impact on human respiratory disease, e [...] Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)

Research

Jump to: Editorial, Other

12 pages, 260 KiB  
Article
The Spectrum of Invasive Fungal Sinusitis in COVID-19 Patients: Experience from a Tertiary Care Referral Center in Northern India
by Surendra Singh Baghel, Amit Kumar Keshri, Prabhakar Mishra, Rungmei Marak, Ravi Sankar Manogaran, Pawan Kumar Verma, Arun Kumar Srivastava, Raj Kumar, Arulalan Mathialagan, Govind Bhuskute, Abhishek Kumar Dubey and Radha Krishan Dhiman
J. Fungi 2022, 8(3), 223; https://doi.org/10.3390/jof8030223 - 24 Feb 2022
Cited by 13 | Viewed by 2855
Abstract
This study aimed to determine the patient demographics, risk factors, which include comorbidities, medications used to treat COVID-19, and presenting symptoms and signs, and the management outcome of COVID-19-associated invasive fungal sinusitis. A retrospective, propensity score-matched, comparative study was conducted at a tertiary [...] Read more.
This study aimed to determine the patient demographics, risk factors, which include comorbidities, medications used to treat COVID-19, and presenting symptoms and signs, and the management outcome of COVID-19-associated invasive fungal sinusitis. A retrospective, propensity score-matched, comparative study was conducted at a tertiary care center, involving 124 patients with invasive fungal sinusitis admitted between April 2021 and September 2021, suffering from or having a history of COVID-19 infection. Among the 124 patients, 87 were male, and 37 were female. A total of 72.6% of patients received steroids, while 73.4% received antibiotics, and 55.6% received oxygen during COVID-19 management. The most common comorbidities were diabetes mellitus (83.9%) and hypertension (30.6%). A total of 92.2% had mucor, 16.9% had aspergillus, 12.9% had both, and one patient had hyalohyphomycosis on fungal smear and culture. The comparative study showed the significant role of serum ferritin, glycemic control, steroid use, and duration in COVID-19-associated invasive fungal disease (p < 0.001). Headache and facial pain (68, 54.8%) were the most common symptoms. The most involved sinonasal site was the maxillary sinus (90, 72.6%). The overall survival rate at the three-month follow-up was 79.9%. COVID-19-related aggressive inflammatory response, uncontrolled glycemic level, and rampant use of steroids are the most important predisposing factors in developing COVID-19-associated invasive fungal sinusitis. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)
12 pages, 308 KiB  
Article
COVID-19-Associated Pulmonary Aspergillosis in a Tertiary Hospital
by García-Clemente Marta, Forcelledo-Espina Lorena, Martínez-Vega Laura, Lanza-Martínez Angela, Leoz-Gordillo Blanca, Albillos-Almaraz Rodrigo, Solís-García Marta, Melón-García Santiago, Pérez-Martínez Liliana, Sánchez-Nuñez Maria Luisa and Peláez-García de la Rasilla Teresa
J. Fungi 2022, 8(2), 97; https://doi.org/10.3390/jof8020097 - 19 Jan 2022
Cited by 15 | Viewed by 3065
Abstract
Our study aims to assess the prevalence of CAPA (COVID-19-associated pulmonary aspergillosis) and describe the associated risk factors and their impact on mortality. A prospective study was conducted. We included patients with COVID-19 disease who were admitted to the ICU with a diagnosis [...] Read more.
Our study aims to assess the prevalence of CAPA (COVID-19-associated pulmonary aspergillosis) and describe the associated risk factors and their impact on mortality. A prospective study was conducted. We included patients with COVID-19 disease who were admitted to the ICU with a diagnosis of respiratory failur. Mycological culture and other biomarkers (calcofluor staining, LFD, LFA, PCR, GM, and B-D-glucan) were performed. A total of 300 patients were included in the study. Thirty-five patients were diagnosed with CAPA (prevalence 11.7%). During admission, 57 patients died (19%), and, in the group of CAPA patients, mortality was 31.4%. In multivariate analysis, independent risk factors associated with CAPA diagnosis were age (OR: 1.05; 95% CI 1.01–1.09; p = 0.037), chronic lung disease (OR: 3.85; 95% CI 1.02–14.9; p = 0.049) and treatment with tocilizumab during admission (OR: 14.5; 95% 6.1–34.9; p = 0.001). Factors independently associated with mortality were age (OR: 1.06; 95% CI 1.01–1.11; p = 0.014) and CAPA diagnosis during admission (OR: 3.34; 95% CI 1.38–8.08; p = 0.007). CAPA is an infection that appears in many patients with COVID-19 disease. CAPA is associated with high mortality rates, which may be reduced by early diagnosis and initiation of appropriate antifungal therapy, so screening of COVID-19 ARDS (acute respiratory distress syndrome) patients for CAPA is essential. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)
9 pages, 6150 KiB  
Article
Analysis of Fungal and Bacterial Co-Infections in Mortality Cases among Hospitalized Patients with COVID-19 in Taipei, Taiwan
by De-En Lu, Shih-Han Hung, Ying-Shih Su and Wen-Sen Lee
J. Fungi 2022, 8(1), 91; https://doi.org/10.3390/jof8010091 - 17 Jan 2022
Cited by 6 | Viewed by 3632
Abstract
Fungal or bacterial co-infections in patients with H1N1 influenza have already been reported in many studies. However, information on the risk factors, complications, and prognosis of mortality cases with coronavirus disease 2019 (COVID-19) are limited. We aimed to assess 36 mortality cases of [...] Read more.
Fungal or bacterial co-infections in patients with H1N1 influenza have already been reported in many studies. However, information on the risk factors, complications, and prognosis of mortality cases with coronavirus disease 2019 (COVID-19) are limited. We aimed to assess 36 mortality cases of 178 hospitalized patients among 339 patients confirmed to have had SARS-CoV-2 infections in a medical center in the Wenshan District of Taipei, Taiwan, between January 2020 and September 2021. Of these 36 mortality cases, 20 (60%) were men, 28 (77.7%) were aged >65 years, and the median age was 76 (54–99) years. Comorbidities such as hypertension, coronary artery disease, and chronic kidney disease were more likely to be found in the group with length of stay (LOS) > 7 d. In addition, the laboratory data indicating elevated creatinine-phosphate-kinase (CPK) (p < 0.001) and lactic acid dehydrogenase (LDH) (p = 0.05), and low albumin (p < 0.01) levels were significantly related to poor prognosis and mortality. The respiratory pathogens of early co-infections (LOS < 7 d) in the rapid progression to death group (n = 7 patients) were two bacteria (22.2%) and seven Candida species (77.8.7%). In contrast, pathogens of late co-infections (LOS > 7 d) (n = 27 patients) were 20 bacterial (54.1%), 16 Candida (43.2%), and only 1 Aspergillus (2.7%) species. In conclusion, the risk factors related to COVID-19 mortality in the Wenshan District of Taipei, Taiwan, were old age, comorbidities, and abnormal biomarkers such as low albumin level and elevated CPK and LDH levels. Bacterial co-infections are more common with Gram-negative pathogens. However, fungal co-infections are relatively more common with Candida spp. than Aspergillus in mortality cases of COVID-19. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)
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14 pages, 1966 KiB  
Article
Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
by Chi-Jung Wu, Cong-Tat Cia, Hsuan-Chen Wang, Chang-Wen Chen, Wei-Chieh Lin, Jen-Chieh Lee, Po-Sheng Chen, Chih-Cheng Hsieh, Wei-Ting Li, Po-Lan Su, Xin-Min Liao, Ming-I Hsieh, Pui-Ching Choi and Wen-Chien Ko
J. Fungi 2022, 8(1), 49; https://doi.org/10.3390/jof8010049 - 4 Jan 2022
Cited by 9 | Viewed by 2514
Abstract
This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factors. The mean time from [...] Read more.
This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factors. The mean time from influenza diagnosis to Aspergillus growth was 4.4 days, and 20 (83.3%) developed IAPA within seven days after influenza diagnosis. All patients were treated in intensive care units and all but one (95.8%) received mechanical ventilation. Aspergillus tracheobronchitis was evident in 6 (31.6%) of 19 patients undergoing bronchoscopy. Positive galactomannan testing of either serum or bronchoalveolar lavage was noted in all patients. On computed tomography imaging, IAPA was characterized by peribronchial infiltrates, multiple nodules, and cavities superimposed on ground-glass opacities. Pure Aspergillus growth without bacterial co-isolation in culture was found in 17 (70.8%) patients. A. fumigatus (15, 62.5%), A. flavus (6, 25.0%), and A. terreus (4, 16.7%) were the major causative species. Three patients had mixed Aspergillus infections due to two species, and two had mixed azole-susceptible and azole-resistant A. fumigatus infection. All patients received voriconazole with an all-cause mortality of 41.6%. Of 14 survivors, the mean duration of antifungal use was 40.5 days. In conclusion, IAPA is an early and rapidly deteriorating complication following influenza that necessitates clinical vigilance and prompt diagnostic workup. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)
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14 pages, 13273 KiB  
Article
The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
by Chien-Ming Chao, Chih-Cheng Lai, Hsuan-Fu Ou, Chung-Han Ho, Khee-Siang Chan, Chun-Chieh Yang, Chin-Ming Chen and Wen-Liang Yu
J. Fungi 2021, 7(11), 922; https://doi.org/10.3390/jof7110922 - 29 Oct 2021
Cited by 7 | Viewed by 2018
Abstract
Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill [...] Read more.
Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill influenza patients remains undefined. The study was retrospectively conducted in three institutes. From 2016 through 2018, all adult patients with severe influenza admitted to an intensive care unit (ICU) were identified. All patients were classified as group 1, patients with concomitant severe influenza and IPA; group 2, severe influenza patients without IPA; and group 3, severe influenza patients without testing for IPA. Overall, there were 201 patients enrolled, including group 1 (n = 40), group 2 (n = 50), and group 3 (n = 111). Group 1 patients had a significantly higher mortality rate (20/40, 50%) than that of group 2 (6/50, 12%) and group 3 (18/11, 16.2%), p < 0.001. The risk factors for IPA occurrence were solid cancer and prolonged corticosteroid use in ICU of >5 days. Group 1 patients had significantly longer hospital stay and higher medical expenditure than the other two groups. The risk factors for mortality in group 1 patients included patients’ Charlson comorbidity index, presenting APACHE II score, and complication of severe acute respiratory distress syndrome. Overall, IPA has a significant adverse impact on the outcome and economic burden of severe influenza patients, who should be promptly managed based on risk host factors for IPA occurrence and mortality risk factors for coinfection with both diseases. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)
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Other

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9 pages, 986 KiB  
Case Report
Association of Tocilizumab and Invasive Aspergillosis in Critically Ill Patients with Severe COVID-19 Pneumonia and Acute Respiratory Distress Syndrome
by Kuo-Lun Wu, Chia-Yuan Chang, Heng-You Sung, Ting-Yu Hu and Li-Kuo Kuo
J. Fungi 2022, 8(4), 339; https://doi.org/10.3390/jof8040339 - 24 Mar 2022
Cited by 3 | Viewed by 2840
Abstract
Coronavirus disease-2019 (COVID-19) causes severe pneumonia and acute respiratory distress syndrome. According to the current consensus, immunosuppressants, such as dexamethasone and anti-interleukin-6 receptor monoclonal antibodies, are therapeutic medications in the early stages of infection. However, in critically ill patients, viral, fungal, and bacterial [...] Read more.
Coronavirus disease-2019 (COVID-19) causes severe pneumonia and acute respiratory distress syndrome. According to the current consensus, immunosuppressants, such as dexamethasone and anti-interleukin-6 receptor monoclonal antibodies, are therapeutic medications in the early stages of infection. However, in critically ill patients, viral, fungal, and bacterial coinfection results in higher mortality. We conducted a single-center, retrospective analysis of 29 mechanically ventilated patients with artificial airways. Patients were adults with confirmed COVID-19 infection and severe pneumonia. Acute respiratory distress syndrome was diagnosed according to the Kigali modification of the Berlin definition. Six patients had invasive pulmonary aspergillosis coinfection based on elevated serum galactomannan levels and/or bronchoalveolar lavage fluid. We present two cases with brief histories and available clinical data. We also conducted a literature review to determine whether immunosuppressants, such as tocilizumab, increase infection risk or invasive aspergillosis in patients with COVID-19. There is no conclusive evidence to suggest that tocilizumab increases coinfection risk. However, further studies are needed to determine the optimal dose, between-dose interval, and timing of tocilizumab administration in patients with COVID-19. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Fungus and Virus Interaction)
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