Concurrent Infection with SARS-CoV-2 and Pneumocystis jirovecii in Immunocompromised and Immunocompetent Individuals
Abstract
:1. Introduction
2. Materials and Methods
Clinical Patterns of PJP
3. Results
3.1. Literature Review
Demographic and Clinical Characteristic of Patients
3.2. Diagnosis and Outcome
3.3. Brief Description of Three Cases in Our Institution
3.4. CASE 1 and 2: Superinfection with P. jirovecii
3.5. CASES 3-Coinfection with P. jirovecii
4. Discussion
5. Conclusions
Supplementary Materials
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Authors and Type of Study | N of Cases | Sex, Age | Comorbidities | Immunosuppression | Radiological Findings | ACL/CD4+ | Diagnostic Tests for PJP | Diagnosis EORT/MSG Cirteria | PJP Treatment, Outcome |
---|---|---|---|---|---|---|---|---|---|
Alanio et al. [34] Prospective observational study 2020 | 10 | 8 M, Mean age 59 | DM: 3, AHT: 6, Obesity: 3, CVD:1, Asthma: 1 | Long-term Steroid therapy: 3 | NR | NR | PCR on RS | Probable PJP | TMP-SMX: 4 IMV: 10 Died: 3 |
Menon et al. [35] Case report 2020 | 1 | F, 83 | CVD, Asthma | Ulcertive Colitis, Long-term Steroid therapy | GGO Cystic Consolidation | 1090/290 | RT-PCR on TA BDG (305 pg/mL) | Probable PJP | TMP-SMX IMV Survived |
Mang et al. [36] Case report 2020 | 1 | M, 52 | AHT, Obesity, HIV | AIDS | GGO Crazy paving | 590/12 | PCR on TA | Probable PJP | TMP-SMX Prednisone IMV Survived |
Coleman et al. [37] Case report 2020 | 1 | M, 54 | HIV, Asthma | None | GGO Cystic | NR/422 | PCR on induced sputum | Probable PJP | TMP-SMX Prednisone no IMV Survived |
Bhat et al. [38] Case report 2020 | 1 | M, 25 | HIV | AIDS | GGO Cyst pneumothorax | NR/32 | IFM on BAL | Probable PJP | TMP-SMX Prednisone IMV Survived |
De Franceso et al. [39] Case report 2020 | 1 | M, 65 | DM, AHT CVD, SOT | SOT (kidney), Long-term steroid therapy | GGO | NR/422 | PCR on sputum | Probable PJP | TMP-SMX Prednisone IMV Died |
Gerber et al. [40] Case series 2020 | 4 | F, 80 | Obesity RA | RA Long-term Steroid therapy | GGO Consolidation Nodules | 300/NR | PCR on BAL | Probable PJP | TMP-SMX IMV Died |
M, 70 | Obesity, CKD, Hematological cancer | HSCT | GGO consolidation | 222/NR | PCR on TA | Probable PJP | TMP-SMX IMV Died | ||
M, 83 | CVD, CKD Asthma | None | GGO Crazy paving | 570/NR | PCR and cytology on BAL | Proven PJP | TMP-SMX No IMV Died | ||
M, 80 | DM, AHT CVD, Asthma | None | GGO Pleural effusion | 600/NR | PCR on TA | Probable PJP | TMP-SMX IMV Died | ||
Kronsten VT et al. [41] Case series 2021 | 2 | M, 28 | DM SOT | Liver transplant Long-term Steroid therapy | GGO | 360/NR | PCR on BAL BDG on BAL 226 pg/mL | Probable PJP | TMP-SMX IMV Survived |
M, 54 | SOT | Liver transplant Long-term Steroid therapy | GGO | 390/NR | PCR on BAL BDG on BAL 227 pg/mL | Probable PJP | TMP-SMX IMV Survived | ||
Gentile I et al. [42] Case series 2021 | 4 | M, 55 | None | Long-term Steroid therapy | GGO | 260/62 | IFM on BAL | Probable PJP | TMP-SMX No IMV Survived |
M, 75 | AHT CVD | Long-term Steroid therapy | GGO | 2220/1021 | None | Possible PJP | TMP-SMX No IMV Survived | ||
F, 63 | NHL | NHL Long-term Steroid therapy | GGO | 240/93 | IFM on BAL | Probable PJP | TMP-SMX No IMV Survived | ||
M, 68 | None | Long-term Steroid therapy | GGO Pleural effusion | 560/141 | None | Possible PJP | TMP-SMX No IMV Survived | ||
Cai et al. [43] Case report 2020 | 1 | M, 72 | RA | RA Long-term Steroid therapy | GGO Acute consolidation | 340/NR | None | Possible PJP | Caspofungin No IMV Survived |
Broadhurst et al. [44] Case report 2021 | 1 | M, 54 | DM AHT HIV | AIDS | GGO | 690/26 | IFM on sputum BDG (>500 pg/mL) | Probable PJP | TMP-SMX No IMV Died |
Jeican et al. [30] Case report 2021 | 1 | M, 52 | AHT CVD Liver disease | None | Consolidation | 190/NR | Positive histopathology | Proven PJP | None No IMV Died |
Rubiano et al. [45] Case report 2021 | 1 | M, 36 | HIV | AIDS | GGO | 400/8 | PCR and IFM on BAL BDG (>500 pg/mL) | Probable PJP | TMP-SMX IMV Died |
Viceconte et al. [46] Case report 2021 | 1 | M, 54 | None | Long-term Steroid therapy | GGO Consolidation | 1265/895 | IFM on BAL BDG positive | Probable PJP | TMP-SMX No IMV Survived |
Larzábal et al. [47] Case report 2020 | 1 | F, 46 | Raynaud syndrome HIV | AIDS | Consolidation | NR/67 | IFM sputum | Probable PJP | TMP-SMX No IMV Survived |
Peng et al. [48] Case report 2020 | 1 | F, 55 | CVD SOT | SOT (kidney) Long-term Steroid therapy | Consolidation | 310/258 | PCR on sputum BDG (89.3 pg/mL) | Probable PJP | Micafungin No IMV Survived |
Mouren et al. [49] Case report 2020 | 1 | M, 65 | Hematological malignancy CLL | CLL | GGO | 200/NR | PCR and IFM on BAL | Probable PJP | TMP-SMX No IMV Survived |
Quintana-Ortega et al. [50] Case report 2021 | 1 | F, 11 | Dermatomyositis | Dermatomyositis Long term Steroid therapy | GGO | 110/NR | IFM on BAL | Probable PJP | TMP-SMX IMV Died |
Anggraeni AT et al. [51] Case report 2021 | 1 | M, 24 | HIV | AIDS | GGO | 176/16 | none | Possible PJP | TMP-SMX No IMV Survived |
Algarín-Lara H et al. [52] Case report 2021 | 1 | M, 63 | Obesity HIV | AIDS | GGO | NR/84 | PCR on BAL | Probable PJP | TMP-SMX IMV Died |
Merchant EA et al. [53] Case report 2021 | 1 | M, 39 | HIV | AIDS | GGO | 860/1 | IFM on BAL | Probable PJP | TMP-SMX IMV Died |
Blaize et al. [54] Observational study 2020 | 2 | F, 38 | DM AHT | none | GGO | NR | PCR on BAL | Probable PJP | None IMV Died |
F/NR | DM AHT Obesity | none | GGO | NR | PCR on BAL | Probable PJP | None IMV Died |
Patterns | Case Classification | P. jirovecii Load (PCR) | Clinical Course | Radiographic Characteristics |
---|---|---|---|---|
Airway colonization | Blaize et al. [54] Alanio et al. [34] | <1000 copies/mL | Typical course of COVID-19 | Similar to COVID-19 Grand-glass opacity |
Superinfection | Gerber et al. [40] Gentile et al. [42] Cai et al. [43] Viceconte et al. [46] Peng et al. [48] Mouren et al. [49] Merchant EA et al. [53] Case 1 and 2 in our institution | >1000 copies/mL | Biphasic illness. The first phase is related to COVID-19, followed by clinical improvement. Subsequently, the second phase of respiratory illness (PJP) starts days or weeks later. | Similar to COVID-19 Diffuse, bilateral, interstitial infiltrates Grand-glass opacity Cysts, lobar infiltrates Solitary or multiple nodules |
Coinfection | Menon et al. [35] Mang et al. [36] Coleman et al. [37] Bhat et al. [38] De Franceso et al. [39] Kronsten VT et al. [41] Broadhurst et al. [44] Jeican et al. [30] Rubiano et al. [45] Larzábal et al. [47] Anggraeni et al. [51] Cases 3 in our institution | >1000 copies/mL | Progressive disease and severe illness despite treatment for COVID-19. Admission to ICU and IMV may be required. | Similar to COVID-19 Grand-glass opacity Lobar or segmental infiltrates Cysts, nodules, effusion data |
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Gioia, F.; Albasata, H.; Hosseini-Moghaddam, S.M. Concurrent Infection with SARS-CoV-2 and Pneumocystis jirovecii in Immunocompromised and Immunocompetent Individuals. J. Fungi 2022, 8, 585. https://doi.org/10.3390/jof8060585
Gioia F, Albasata H, Hosseini-Moghaddam SM. Concurrent Infection with SARS-CoV-2 and Pneumocystis jirovecii in Immunocompromised and Immunocompetent Individuals. Journal of Fungi. 2022; 8(6):585. https://doi.org/10.3390/jof8060585
Chicago/Turabian StyleGioia, Francesca, Hanan Albasata, and Seyed M. Hosseini-Moghaddam. 2022. "Concurrent Infection with SARS-CoV-2 and Pneumocystis jirovecii in Immunocompromised and Immunocompetent Individuals" Journal of Fungi 8, no. 6: 585. https://doi.org/10.3390/jof8060585