Fungal infections complicating COVID-19 treatment, fuelling mortality, expert warns

Fungal infections complicating COVID-19 treatment, fuelling mortality, expert warns

Yusuff Moshood<

A medical epidemiologist with the Centres for Disease Control and Prevention, Dallas Smith, says better attention should be paid to COVID-19 patients who developed fungal diseases.

According to the health expert, undiagnosed and poorly treated fungal infections are fuelling deaths of COVID-19 patients.

Dan Smith who is an Epidemic Intelligence Service Officer of the CDC noted that recent studies have revealed a growing incidence of complications and mortality in COVID-19 patients with fungal infections.

Speaking during a webinar organised by the International Pharmaceutical Federation, Smith said a recent study conducted in the United Kingdom which looked at COVID-19 patients in ICU to see the prevalence of fungal infection in COVID-19 patients revealed that there is a high rate of mortality in COVID-19 patients co-infected with fungal diseases.

“The mortality was over 50 per cent compared to COVID-19 patients without fungal diseases. This is why we should be looking more at the fungal co-infection with COVID-19 because we are seeing a very high mortality rate.

“So, when you look at COVID-19 patients with fungal diseases, the mortality rate is around 53 per cent compared to those with just only COVID-19 which is just 31 per cent. That is a huge gap in the increase in mortality. 

“Also, one of the things we have seen is that some of these fungal diseases are misdiagnosed or even underdiagnosed. So, if we do not properly diagnose and treat these fungal diseases in patients with COVID-19, we may see up to 90 per cent mortality.

“That is why we must be raising awareness about these fungal diseases and the need for us to provide treatment for patients,” he said.

Smith stated further that COVID-19 associated pulmonary aspergillosis (CAPA) described as invasive pulmonary aspergillosis occurring in COVID-19 patients and also as invasive fungal infections can be picked up indoors or outdoor because it is very common in the environment.

“There have been reports that we are having invasive aspergillosis in severe influenza cases. 

“So, some of these patients are ICU and being ventilated and they end up developing influenza-related aspergilllosis. This is completely new to us, but we are seeing a high rate in this pandemic period. We are also seeing that there is low awareness and infrequent testing for COVID-19 associated aspergillosis.

“In the last one year and a half, we have seen a large number of reports of CAPA, mostly from western Europe. However, we have also seen that it has spread across the world,” he said.

Also speaking at the webinar, Dr. Stacey Konkle, who is also an epidemic intelligence service officer with the CDC called for more advocacy on Post COVID conditions, noting that there is a lot of work to be done to help patients with the conditions.

Konkle who is a member of the 2020 class of the CDC said Post COVID conditions is an umbrella term for a wide range of physical and mental health consequences present four or more weeks after SARS-COV-2 infection.

She explained that the conditions also affect COVID-19 patients who had a mild or asymptomatic acute infection and include a wide range of symptoms which includes respiratory and cardiac symptoms.

Other symptoms of said Post COVID conditions, Konkle said, are fatigue, anxiety, palpitations, joint pain, change in renal function nervous, and circulatory systems.

Konkle, who is an epidemiologist, noted that while the WHO recently published clinical case definition of Post COVID condition, the global health agency’s definition is more restricted, stressing that post COVID includes a wide range of physical and mental health consequences experienced by patients.

Konkle said that the CDC has provided educational web pages to educate people on Post-COVID conditions, noting that persons at higher for SARS-COV-2 and severe infection may also be at higher risk for Post-COVID conditions.

She disclosed that while there have been some studies on Post COVID conditions, there is a need to have studies that not only cover different populations but that also access the severity and impact of symptoms on the quality of life and daily activities of those affected.

“There is a lot of work to be done on Post-COVID condition given the size of the pandemic. 

“We need to evaluate models of care with a focus on health equity to improve access to care.

“We need to establish and maintain partnerships with clinicians, professional societies, affected populations and other agencies and organisations,” she said.

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