Cutaneous manifestations of a 21st century worldwide fungal epidemic possibly complicating the COVID-19 pandemic to jointly menace mankind

Honey therapies for dermatological disorders: more than just a sweet elixir

Honey possesses antibacterial, anti-inflammatory, and healing properties that benefit wound healing and tissue regeneration. For centuries, honey has been utilized in traditional medicine as a binder or vehicle for creams and lotions and also for therapeutic purposes. The overuse of antibiotics and antimicrobial agents leading to drug resistance has emphasized the resurgence of honey's application in wound care. For many dermatological disorders, there is an interest in developing therapeutics with fewer side effects than traditional therapies and enhanced wound healing abilities to expedite tissue regeneration. This paper reviews the properties and components of honey that contribute to its wound-healing-based applications, the types of honey employed in medicine, and its dermatological applications. Based on the evidence from case reports, clinical trials, and in vitro studies, honey has been characterized as a safe, cost-effective, and readily available treatment option for many skin conditions, including microbial infections, atopic dermatitis, psoriasis, necrotizing fasciitis, ulcers, as well as thermal and other types of wounds.

Ninhydrin as a novel DNA hybridization indicator applied to a highly reusable electrochemical genosensor for Candida auris

This work reports a simple strategy for Candida auris genomic DNA (gDNA) detection, a multi-resistant fungus associated with nosocomial outbreaks in healthcare settings, presenting high mortality and morbidity rates. The platform was developed using gold electrode sensitized with specific DNA capture probe and ninhydrin as a novel DNA hybridization indicator. The genosensor was able to detect C. auris in urine sample by differential pulse voltammetry and electrochemical impedance spectroscopy. The biosensor's analytical performance was evaluated by differential pulse voltammetry, detecting up to 4.5 pg μL^-1 of C. auris gDNA in urine (1:10, V/V). Moreover, the genosensor was reused eight times with no loss in the current signal response. The genosensor showed selectivity and stability, maintaining 100% of its response up to 80 days of storage. In order to analyze interactions of single and double-stranded DNA with ninhydrin, SEM, AFM and molecular dynamics studies followed by docking simulations were performed. Theoretical calculations showed ninhydrin interactions more favorably with dsDNA in an A-T rich binding pocket rather than with the ssDNA. Therefore, the proposed system is a promising electrochemical detection device towards a more accurate detection of C. auris gDNA in biological samples.

Candida spp. co-infection in COVID-19 patients with severe pneumonia: Prevalence study and associated risk factors

Background

Invasive fungal infections (IFI) are increasing in prevalence in recent years. In the last few months, the rise of COVID-19 patients has generated a new escalation in patients presenting opportunistic mycoses, mainly by Aspergillus. Candida infections are not being reported yet.

Objectives

We aimed to determine the prevalence of systemic candidiasis in patients admitted to ICUs due to severe pneumonia secondary to SARS-CoV-2 infection and the existence of possible associated risk factors that led these patients to develop candidiasis.

Patients/methods

We designed a study including patients with a confirmed diagnosis of COVID-19.

Results

The prevalence of systemic candidiasis was 14.4%, and the main isolated species were C. albicans and C. parapsilosis. All patients that were tested positive for Candida spp. stayed longer in the ICU in comparison to patients who tested negative. Patients with candidiasis had higher MuLBSTA score and mortality rates and a worse radiological involvement. In our study, Candida spp. isolates were found in patients that were submitted to: tocilizumab, tocilizumab plus systemic steroids, interferon type 1β and Lopinavir-Ritonavir.

Conclusions

Results suggested a high prevalence of systemic candidiasis in severe COVID-19-associated pneumonia patients. Patients with Candidiasis had the worst clinical outcomes. Treatment with tocilizumab could potentialize the risk to develop systemic candidiasis.

Public health issues with Candida auris in COVID-19 patients

The ongoing pandemic of coronavirus disease 2019 (COVID‐19) has overwhelmed a number of medical facilities as well as a few entire health‐care systems. A novel issue co‐incident with the expeditious deployment of specialty care units for COVID‐19 inpatients is the worldwide epidemic of Candida auris infections. Since its first identification and classification in Japan in 2009, it has spread globally. This threat was predicted as C. auris has a high mortality rate, cryptic fomite spread, frequent misidentification since conventional methods do not detect it, and multidrug‐resistance. Since the April 2020 warning at the start of the COVID‐19 pandemic in the United States, C. auris has been delineated as an increasingly consequential source of significant nosocomial infections, emphasizing the added hazard of C. auris to COVID‐19 inpatients, particularly those in intensive care units.

Candida auris was a worldwide nosocomial epidemic prior to COVID‐19; it remains so!

This 21st century worldwide fungal epidemic complicates the COVID‐19 pandemic to jointly menace mankind

C. auris is multi‐drug resistant, requires expensive mass spectrometry equipment to diagnose, and has a high mortality rate in intensive care units

This nosocomial infection may persist on dry linen, sheets, floors, cell phones, and medical equipment for weeks

We propose a policy that documents the presence or absence of this invasive Candidal species in intensive care units during this COVID‐19 pandemic to aggressively eliminate it.

COVID-19-specific skin changes related to SARS-CoV-2: Visualizing a monumental public health challenge

The novel coronavirus SARS-CoV-2 has caused coronavirus disease-2019, known as COVID-19, now a pandemic stressing millions of individuals worldwide. COVID-19 is a systemic respiratory infection that may have dermatologic signs and systemic sequelae, a devastating public health challenge with parallels to the two great influenza pandemics of the last century. Skin lesions linked with COVID-19 have been grouped into six categories, with three distinct indicative patterns: vesicular (varicella-like), vasculopathic, and chilblains-like (including “COVID toes” and “COVID fingers”) plus the following three less suggestive patterns: dermatitic, maculopapular, and urticarial morphologies. Vasculopathic changes are the most concerning, in some patients, reflecting a devastating blood clotting dysfunction. We discuss the ways to detect, prevent, and treat COVID-19, keeping in mind the context of possible cutaneous markers of COVID-19 to enhance detection.

What we have learned from the COVID-19 pandemic: Time to think outside the box, maybe far outside

The coronavirus disease 2019 pandemic has had a profound effect on our lives and careers; this presentation explores some of the lessons we have learned from it and others that it may yet teach us. Socioeconomic effects have been profound, not all of them favorable. Travel and meeting activities, as well as many other activities, have been severely restricted. Social unrest has become intense, and it may have questionable political consequences, as the United States is undergoing a contested election result.

COVID-19 with dermatologic manifestations and implications: An unfolding conundrum

The novel coronavirus SARS‐CoV‐2 has caused Coronavirus Disease 2019, widely known as COVID‐19, now a pandemic with extraordinary infectivity, mortality, and fomite adhesiveness. We delineate cutaneous manifestations of COVID‐19, some of which may represent adverse cutaneous drug reactions, and skin changes associated with COVID‐19 lifestyle alterations in patients and health care workers. We review COVID‐19 from both a dermatologic and public health perspective.