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Johansson AK, Omar R, Lehmann S, Sannevik J, Mastrovito B, Johansson A. General and orofacial symptoms associated with acute and long COVID in 80- and 90-year-old Swedish COVID-19 survivors. J Dent 2024; 141:104824. [PMID: 38145803 DOI: 10.1016/j.jdent.2023.104824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 12/27/2023] Open
Abstract
OBJECTIVES To describe acute and long COVID-19 symptoms among older elderly Swedes and to find predictive factors for the development symptoms associated with acute and long COVID. MATERIAL AND METHODS A questionnaire about general and oral health was mailed to all 80-year-olds (born 1942, n = 6299) and 90-year-olds (born 1932, n = 1904) in two Swedish counties. Participants reporting COVID-19 were asked to complete an additional questionnaire. RESULTS Overall response rate was 66 % (n = 5375). Affirmative responses to having been sick/tested positive for COVID-19 were reported by 577 persons. Response rate to the COVID-19 questionnaire was 49 %. The majority (88 %) reported some general symptoms during the acute stage while 44 % reported orofacial symptom/s. Reporting of any form of long-COVID general symptoms was 37 and 35 % for orofacial symptoms. Predictive factors for contracting COVID-19 (based on self-report from 2017) were living in elderly housing/senior care facility (OR 1.6, CI 1.0-2.3), large number (>10) of weekly social contacts (OR 1.5, CI 1.3-1.9), being married (OR 1.4, CI 1.1-1.7) and high school/university education (OR 1.3 CI 1.1-1-6). The highest odds ratio for general symptoms of long-COVID were a single complete denture (OR 5.0, CI 2.0-12.3), reporting bad breath (OR 3.7, CI 1.9-7.2) and daytime dry mouth (OR 2.2, CI 1.1-4.2). Regarding long-COVID orofacial symptoms, the highest risk factors were bad breath (OR 3.8, CI 1.9-7.5) and a single complete denture in one jaw (OR 3.4, CI 1.2-9.8). CONCLUSION Long-COVID general and orofacial symptoms are common among older elderly COVID-19 survivors CLINICAL SIGNIFICANCE: Oral microorganisms may be responsible for development of long-COVID symptoms. Health personnel managing COVID-19 patients should carefully examine dental status, especially in those having acrylic-based removable dentures, for oral signs and symptoms. If found, rigorous oral hygiene procedures should be carried out including cleaning/disinfection of the denture.
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Affiliation(s)
- Ann-Katrin Johansson
- Department of Clinical Dentistry - Cariology, Faculty of Medicine, University of Bergen, Årstadveien 19, Bergen 5009, Norway.
| | - Ridwaan Omar
- Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Sverre Lehmann
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Berit Mastrovito
- Dental Commissioning Unit, Östergötland County Council, Linköping, Sweden
| | - Anders Johansson
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Dentistry - Prosthodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
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Wang Y, Jiang T, Shen L. Cross-cultural adaptation and validation of the Chinese version of the intensive care oral care frequency and assessment scale. Heliyon 2024; 10:e24025. [PMID: 38268597 PMCID: PMC10806095 DOI: 10.1016/j.heliyon.2024.e24025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024] Open
Abstract
Objectives The objective of this study was to translate the Intensive Care Oral Care Frequency and Assessment Scale into Chinese and to evaluate its reliability and validity in Chinese ICU patients. Methods This study was conducted using a cross-sectional survey design in ICUs of three tertiary hospitals in Huai'an and Taizhou from October 2022 to April 2023. The Chinese version of the Intensive Care Oral Care Frequency and Assessment Scale (C-ICOCFAS) was developed by expert consultation and cultural adaptation according to the two-person verbatim translation-back translation criteria described in the Brislin model. Item analysis was conducted using correlation analysis, and validity analysis included content validity, construct validity, and criterion validity. Reliability analyses included Cronbach's alpha coefficient, Guttman split-half reliability, and interrater reliability. Results The Chinese version of the scale consisted of one dimension and nine items, consistent with the original version. Exploratory factor analysis showed KMO = 0.891, and the cumulative variance contribution reached 65.534 %. The confirmatory factor analysis indicated a good fit, χ2/df = 2.124, NFI = 0.950, GFI = 0.942, IFI = 0.973, CFI = 0.973, SRMR = 0.037, and RMSEA = 0.073. The content validity of the scale was 0.97, and the content validity of the items ranged from 0.83 to 1.00; the criterion validity was 0.969; the Cronbach's alpha coefficient was 0.919; the total item correlation coefficient was 0.725-0.831; the Guttman split-half reliability was 0.919; and the interrater reliability was 0.885. Conclusion The C-ICOCFAS has good reliability and validity and can effectively guide nurses in the frequency of oral care for ICU patients. Implications for clinical practice This tool can significantly improve the level of oral care among ICU patients and further promote the health and safety of patients. These findings can help clinical nursing experts to better understand and master the use of scales and standards to improve nursing.
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Affiliation(s)
- Yuecong Wang
- Intensive care unit, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China
- Department of nursing, college of medical science, Huzhou University, Huzhou, Zhejiang, China
| | - Tianxiang Jiang
- Intensive care unit, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China
- School of Nursing, Dalian University, Dalian, Liaoning, China
| | - Li Shen
- Intensive care unit, Huaian City Second People's Hospital, Huaian, Jiangsu, China
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3
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San Martín Andrade D, Cárdenas Amendaño CA, Solórzano Cuenca AB, Ulloa Pacheco JM, Medina-Sotomayor P. [Candida albicans: risk factor in covid-19 patients]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 10:e132. [PMID: 38390607 PMCID: PMC10880693 DOI: 10.21142/2523-2754-1004-2022-132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/02/2022] [Indexed: 02/24/2024] Open
Abstract
The Candida Albicans fungus in our body can cause various conditions and will depend directly on the systemic condition of the host. Patients with COVID-19 who have previously presented this fungus can increase the likelihood of morbidity and mortality, since this microorganism can be located in areas that correspond to the respiratory system, generating a functional deficit. If not treated timely, it will proliferate into the blood and digestive system. Many patients with respiratory difficulties on account of this condition require mechanical ventilation to combat it. Objective To relate the presence of Candida Albicans as an aggravating factor in patients with COVID-19. Materials and methods: A literature review took place using the Redalyc, Scielo, PubMed, Research gate, Science direct, Google Scholar databases. The inclusion criteria used were: articles in English and Spanish, along with articles published from 2020 up to date. There were 65 scientific articles that met the search criteria and were analyzed. The analysis determined that oral candidiasis negatively affects patients with COVID-19 infection, increasing the risk of admission to the ICU with the use of artificial ventilators.
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Affiliation(s)
- Daniela San Martín Andrade
- Carrera de Odontologia de la Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , Universidad Católica de Cuenca Carrera de Odontologia Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Cristopher Andrés Cárdenas Amendaño
- Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , , Universidad Católica de Cuenca Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Allison Brigitte Solórzano Cuenca
- Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , , Universidad Católica de Cuenca Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Johanna Maribel Ulloa Pacheco
- Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , , Universidad Católica de Cuenca Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Priscilla Medina-Sotomayor
- Carrera de Odontologia de la Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , Universidad Católica de Cuenca Carrera de Odontologia Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
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Ali MO, Alva B, Nagaral S, Patil R, Khan MU, Tiwari DA. Association Between Candida albicans and COVID-19 in Complete Denture Wearers: An Observational Study. Cureus 2023; 15:e47777. [PMID: 38022199 PMCID: PMC10676466 DOI: 10.7759/cureus.47777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The phenomenon of coronavirus disease 2019 (COVID-19)-related candidiasis is gaining increased attention and acknowledgment as an integral component of the severe consequences of COVID-19. The aim of the present study was to assess the association between Candida albicans and COVID-19 in complete denture wearers. Materials and methods An observational study was conducted on 45 complete denture wearers, who were divided into three groups as follows: Group 1, 15 subjects with mild to moderate COVID-19 infection; Group 2, 15 subjects with severe COVID-19 infection; and Group 3, 15 subjects without COVID-19 infection. Mean colony forming units (CFU) were observed on agar plates containing Sabouraud dextrose in the salivary samples of the participants. Analysis of variance, followed by post-hoc analysis by Tukey's test, was used to compare CFU between the groups. Pearson's correlation coefficient was used to study the correlation between variables. Results The highest average colony-forming units of Candida albicans were observed in Group 2, followed by Group 1, compared to the control group, and a significant (p<0.001) difference was found. A weak positive correlation was found between the age of the patients and the duration of denture usage, as well as between age and the counts of Candida albicans in Groups 1 and 3. This correlation was more pronounced in Group 3. A strong positive correlation was observed in all groups between the Candida albicans count and the duration of denture usage by the patients. Conclusion The association between Candida albicans and denture wear was compounded by the presence of COVID-19. Consequently, the timely identification of Candida albicans infection in patients with COVID-19 is important to establish more efficacious approaches for antifungal treatment and prophylactic interventions.
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Affiliation(s)
- Mohd Osman Ali
- Department of Dentistry, Deccan College of Medical Sciences, Hyderabad, IND
| | - Babashankar Alva
- Department of Dentistry, Faculty of Dentistry, Ramaiah University of Applied Sciences, Bangaluru, IND
| | - Suresh Nagaral
- Department of Prosthodontics, JMF's ACPM Dental College, Dhule, IND
| | - Rohit Patil
- Department of Prosthodontics, JMF's ACPM Dental College, Dhule, IND
| | | | - Durgesh A Tiwari
- Department of Conservative Dentistry and Endodontics, Yogita Dental College and Hospital, Khed, IND
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Lisovskaya S, Isaeva GS, Nikolaeva I, Guseva S, Gainatullina L, Chumarev N. COLONIZATION AND AZOLE RESISTANCE OF OROPHARYNGEAL CANDIDA FUNGI IN INTENSIVE CARE PATIENTS WITH COVID-19. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2023. [DOI: 10.15789/2220-7619-caa-2059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Patients with COVID-19 are susceptible to developing oropharyngeal candidiasis and invasive candidiasis. Invasive fungal infections can complicate the clinical course of COVID-19 and are associated with a substantially increased mortality. An important reason for the successful treatment of candidiasis is to determine the sensitivity of clinical fungal isolates to antimycotics. A microbiological study of oropharyngeal swabs was performed in 54 patients aged 33 to 94 years (mean age 67.4 years) with severe and extremely severe COVID-19, who were treated in the intensive care unit at the height of clinical manifestations. Most patients (95%) had comorbidities: hypertension (68.5%), diabetes mellitus (24%), coronary artery disease (22.2%), chronic heart failure (38.9%), obesity (23.8%), cardiac arrhythmias (20.4%), chronic cerebral ischemia (56.1%), varicose veins of the lower extremities (5.5%), chronic kidney disease (20.4%), liver cirrhosis (5.5%), HIV infection (5.5%). A comparative analysis of oropharyngeal microbial biocenosis showed differences in the frequency of occurrence of opportunistic microbial species, as well as in the number of members in microbial associations. Polyspecific fungal-bacterial associations were more common and dominated polyspecific bacterial associations. According to the results, a high frequency of oropharyngeal colonization in patients with severe COVID-19 by strains of fungi of the genus Candida was established. The vast majority of strains of fungi of the genus Candida (85.2%) were resistant to antimycotics of the azole group. A high frequency (85.2%) of oropharyngeal colonization in resuscitation patients with azole-resistant strains of fungi of the genus Candida was revealed. C. albicans dominated among Candida. C. albicans was isolated in 37 (68.5%) patients, C. pararapsilosis - in 6 (11.1%), C. tropicalis - in 3 (5.5%), C. krusei - in 2 (3.7%) %), C. kefyr - in 1 (1.9%), C. glabrata - in 1 (1.9%) patient. In 11 (20.4%) patients, associations of C. albicans and other Candida species were identified. The level of fungi in the material was etiologically significant (104 105 CFU/tamp.) in 80% of patients. The vast majority of strains (more than 70%) were resistant to fluconazole and voriconazole, which should be taken into account when prescribing candidiasis therapy in patients with COVID-19. The MIC for fluconazole against C. albicans strains was 1024 g/ml for 4 isolates, 512 g/ml for 7 isolates, and 128 g/ml for 15 isolates. The maximum MIC values for voriconazole against C. albicans was 256 g/ml.
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Oral Candidiasis in Adult and Pediatric Patients with COVID-19. Biomedicines 2023; 11:biomedicines11030846. [PMID: 36979825 PMCID: PMC10045279 DOI: 10.3390/biomedicines11030846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Oral Candidiasis (OC) is an opportunistic fungal infection of the oral cavity, frequently reported under local and systemic predisposing circumstances. While the recurrence of OC HIV-infected subjects has been well described and reported, the association between oral candidiasis and the SARS-CoV-2 infection is a recent finding that still is worthy of further study. The present paper focuses on this novel association, reporting the incidence and prevalence of OC occurring during and after COVID-19 and the possible etiopathogenic mechanisms underlying the onset of OC in COVID-19 subjects. The work found that the immune inflammatory hypo reactions and immunosuppression found in children and adults with COVID-19 could favor the proliferation colonization of Candida species and the following infection. At the same time, poor oral hygiene and iatrogenic causes seem to be the main risk factors.
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Redfern J, Tosheva L, Malic S, Butcher M, Ramage G, Verran J. The denture microbiome in health and disease: an exploration of a unique community. Lett Appl Microbiol 2022; 75:195-209. [PMID: 35634756 PMCID: PMC9546486 DOI: 10.1111/lam.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022]
Abstract
The United Nations suggests the global population of denture wearers (an artificial device that acts as a replacement for teeth) is likely to rise significantly by the year 2050. Dentures become colonized by microbial biofilms, the composition of which is influenced by complex factors such as patient’s age and health, and the nature of the denture material. Since colonization (and subsequent biofilm formation) by some micro‐organisms can significantly impact the health of the denture wearer, the study of denture microbiology has long been of interest to researchers. The specific local and systemic health risks of denture plaque are different from those of dental plaque, particularly with respect to the presence of the opportunist pathogen Candida albicans and various other nonoral opportunists. Here, we reflect on advancements in our understanding of the relationship between micro‐organisms, dentures, and the host, and highlight how our growing knowledge of the microbiome, biofilms, and novel antimicrobial technologies may better inform diagnosis, treatment, and prevention of denture‐associated infections, thereby enhancing the quality and longevity of denture wearers.
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Affiliation(s)
- J Redfern
- Department of Natural Sciences, Faculty of Science and Engineering Manchester Metropolitan University UK
| | - L Tosheva
- Department of Natural Sciences, Faculty of Science and Engineering Manchester Metropolitan University UK
| | - S Malic
- Department of Life Sciences, Faculty of Science and Engineering Manchester Metropolitan University UK
| | - M Butcher
- Department of Oral Sciences, Glasgow Dental School, School of Medicine, Dentistry and Nursing University of Glasgow UK
| | - G Ramage
- Department of Oral Sciences, Glasgow Dental School, School of Medicine, Dentistry and Nursing University of Glasgow UK
| | - J Verran
- Department of Life Sciences, Faculty of Science and Engineering Manchester Metropolitan University UK
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Kundu R, Singla N. COVID-19 and Plethora of Fungal Infections. CURRENT FUNGAL INFECTION REPORTS 2022; 16:47-54. [PMID: 35432691 PMCID: PMC8994097 DOI: 10.1007/s12281-022-00432-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 12/15/2022]
Abstract
Purpose of Review Severe-acute respiratory coronavirus 2 (SARS-CoV-2) causing corona virus disease 2019 (COVID-19) has been the single most important pathogen driving health care delivery system for the last one and half years. Now, as the time is passing, many issues related to co-infections/secondary infections/superinfections in COVID-19 patients are emerging. The literature is getting enriched everyday by addition of reports from all over the world for the same. The purpose of this review is to decipher the plethora of fungal infections in COVID-19. Recent Findings COVID-19 infection along with it brought many risk factors namely lung injury, immunosuppression, need for oxygen therapy, monoclonal antibodies, steroid therapy, etc. which are known predisposing factors for fungal infections. Rather the extent and severity of fungal pathogens has been so much that it has led to new terminologies like CAC (COVID-19-associated Candida), CAPA (COVID-19-associated pulmonary aspergillosis) and CAM (COVID-19-associated mucormycosis). There is increase in invasiveness of Candida, prevalence of aspergillosis in COVID-19 damaged lung and outbreak of mucormycosis in COVID-19 patients resulting in “double trouble,” keeping laboratory personnel, clinicians, and intensivists on their toes in managing these patients. Summary Awareness and understanding regarding these possible complications is necessary to decrease the morbidity and mortality among patients. The COVID-19 and fungal coinfections may bring more insight into ways of pathogenesis of fungal infections, need for better antifungal agents, quick diagnostic modalities, and better management policies in the near future.
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Affiliation(s)
- Reetu Kundu
- Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Singla
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
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Ahmed N, Mahmood MS, Ullah MA, Araf Y, Rahaman TI, Moin AT, Hosen MJ. COVID-19-Associated Candidiasis: Possible Patho-Mechanism, Predisposing Factors, and Prevention Strategies. Curr Microbiol 2022; 79:127. [PMID: 35287179 PMCID: PMC8918595 DOI: 10.1007/s00284-022-02824-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/23/2022] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is threatening public health. A large number of affected people need to be hospitalized. Immunocompromised patients and ICU-admitted patients are predisposed to further bacterial and fungal infections, making patient outcomes more critical. Among them, COVID-19-associated candidiasis is becoming more widely recognized as a part of severe COVID-19 sequelae. While the molecular pathophysiology is not fully understood, some factors, including a compromised immune system, iron and zinc deficiencies, and nosocomial and iatrogenic transmissions, predispose COVID-19 patients to candidiasis. In this review, we discuss the existing knowledge of the virulence characteristics of Candida spp. and summarize the key concepts in the possible molecular pathogenesis. We analyze the predisposing factors that make COVID-19 patients more susceptible to candidiasis and the preventive measures which will provide valuable insights to guide the effective prevention of candidiasis in COVID-19 patients.
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Affiliation(s)
- Nafisa Ahmed
- Biotechnology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Maiesha Samiha Mahmood
- Biotechnology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Md. Asad Ullah
- Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Yusha Araf
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Tanjim Ishraq Rahaman
- Department of Biotechnology and Genetic Engineering, Faculty of Life Sciences, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Abu Tayab Moin
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
| | - Mohammad Jakir Hosen
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Samaranayake LP, Fakhruddin KS, Ngo HC, Bandara MHMN, Leung YY. Oro-facial Mycoses in Coronavirus Disease-2019 (COVID-19): A Systematic Review. Int Dent J 2022; 72:607-620. [PMID: 35367044 PMCID: PMC8885299 DOI: 10.1016/j.identj.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022] Open
Abstract
Objectives Studies reviewing orofacial mycoses in coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2) infection are sparse. Here we review the major oral and maxillofacial mycoses of COVID-19, the associated comorbidities, and the probable precipitating factors. Methods English-language manuscripts published between March 2020 and October 2021 were searched using PubMed, OVID, SCOPUS, and Web of Science databases, using appropriate keywords. Results We identified 30 articles across 14 countries, which met the inclusion criteria of PRISMA guidelines. These yielded a total of 292 patients with laboratory-confirmed COVID-19, 51.4% (n = 150) of whom presented with oral and maxillofacial fungal infections, mainly comprising candidosis, mucormycosis, and aspergillosis. Candida infections were the most prevalent, present in 64% (n = 96), followed by mucormycosis, and only a single case of aspergillosis was noted. Oral and maxillofacial mycoses were predominantly seen in those with comorbidities, especially in those with diabetes (52.4%). Oral mucormycosis was noted in 8.6% (n = 13) and mainly manifested on the hard palate. An overall event rate of oral/maxillofacial mucormycosis manifestation in patients with COVID-19 with diabetes mellitus type 1/2 was about 94% (49/52; 95% confidence interval, 0.73%-0.89%), implying a very high association between diabetes mellitus and the latter condition. All fungal infections appeared either concurrently with COVID-19 symptoms or during the immediate recovery period. Conclusions SARS-CoV-2 infection–related immunosuppression, steroid therapy, as well as comorbidities such as diabetic hyperglycemia appear to be the major predisposing factors for the onset of oral and maxillofacial mycoses in patients with COVID-19 across all age groups.
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11
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Karnik K, Wu Y, Ruddy S, Quijano-Rondan B, Urban C, Turett G, Yung L, Prasad N, Yoon J, Segal-Maurer S. Fatal case of disseminated cryptococcal infection and meningoencephalitis in the setting of prolonged glucocorticoid use in a Covid-19 positive patient. IDCases 2022; 27:e01380. [PMID: 35013707 PMCID: PMC8734083 DOI: 10.1016/j.idcr.2022.e01380] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 12/15/2022] Open
Abstract
Based on the RECOVERY trial, glucocorticoids have become the mainstay of treatment for COVID-19, thus increasing the risk of opportunistic infections. We report a case of disseminated Cryptococcus neoformans with documented meningoencephalitis in a patient with severe COVID-19 in the setting of prolonged glucocorticoid administration with poor outcome likely due to adrenal involvement.
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Affiliation(s)
- Krupa Karnik
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Yuexiu Wu
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Samantha Ruddy
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Bladimir Quijano-Rondan
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Carl Urban
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,Weill Cornell Medicine, Cornell University, New York, New York 10065, United States
| | - Glenn Turett
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Lok Yung
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Nishant Prasad
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - James Yoon
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States
| | - Sorana Segal-Maurer
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, New York 11355, United States.,Weill Cornell Medicine, Cornell University, New York, New York 10065, United States
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Ghosh A, Sarkar A, Paul P, Patel P. The rise in cases of mucormycosis, candidiasis and aspergillosis amidst COVID19. FUNGAL BIOL REV 2021; 38:67-91. [PMID: 34548877 PMCID: PMC8445778 DOI: 10.1016/j.fbr.2021.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022]
Abstract
The Coronavirus outbreak globally has changed the medical system and also led to a shortage of medical facilities in both developing and underdeveloped countries. The COVID19 disease, being novel in nature along with high infectivity and frequent mutational rate, has been termed to be fatal across the globe. The advent of infection by SARS-CoV-2 has brought a myriad of secondary complications and comorbidities resulting in additional challenges to the health care system induced by novel therapeutic procedures. The emerging variant with respect to the Indian subcontinent and the associated genetic mutations have worsened the situation at hand. Proper clinical management along with epidemiological studies and clinical presentations in scientific studies and trials is necessary in order to combat the simultaneous waves of emerging strains. This article summarizes three of the major fungal outbreaks in India namely mucormycosis, candidiasis and aspergillosis, and elaborates their subtypes, pathogenesis, symptoms and treatment and detection techniques. A detail of future therapeutics under consideration are also elaborated along with a general hypothesis on how COVID19 is related to immunological advances leading to major widespread fungal infection in the country. The factors that contribute in promoting virus proliferation and invasive fungal infections include cell-mediated immunity, associated immunocompromised conditions and treatment protocols that slows down immune mechanisms. To better comprehend a fungal or bacterial outbreak, it is very important to conduct audits mediated through multicenter national and state research teams for recognizing patterns and studying current cases of fungal infection in both healthy and comorbid groups of COVID19 patients.
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Affiliation(s)
- Asmita Ghosh
- Department of Biotechnology, Heritage Institute of Technology, Kolkata 700107, West Bengal, India
| | - Anusua Sarkar
- Department of Biotechnology, Heritage Institute of Technology, Kolkata 700107, West Bengal, India
| | - Pubali Paul
- Department of Biotechnology, Heritage Institute of Technology, Kolkata 700107, West Bengal, India
| | - Parth Patel
- H. K. College of Pharmacy, Jogeshwari West, Mumbai 400102, Maharashtra, India
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