Infection with microscopic fungi can worsen the respiratory distress of patients with a severe form of Covid-19, going as far as doubling their death rate, according to a study of 576 patients in intensive care.
This study, called MYCOVID and published in the scientific journal The Lancet Respiratory Medicine, also found a high number of episodes of proven or probable invasive fungal infections (22.4%), such as invasive aspergillosis.
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“
Invasive aspergillosis is a disease that is well known in the hospital in very immunocompromised patients. In recent years, we have seen it appear in people who had severe influenza with acute respiratory distress syndrome (ARDS)
", explained to AFP Professor Jean-Pierre Gangneux, head of the parasitology and mycology laboratory of Rennes University Hospital and study coordinator. At the start of the Covid-19 epidemic, "
when we saw the clinical pictures of the Covid, which looked like severe flu, we said to ourselves that we absolutely had to put in place surveillance
", he added.
Started in April 2020, MYCOVID was initially to follow 250 patients from their entry to their discharge from intensive care.
The study finally exceeded 500 patients in 18 hospitals across France.
"
The biggest world series
" in the field, according to Professor Gangneux.
Mushrooms everywhere in the air
For patients with a severe form of Covid and also infected with invasive aspergillosis, the study shows a doubling of mortality (61.8% against 32.1%). "
This co-infection with a fungus is a major event that worsens the aftermath of a serious Covid infection
", underlines the researcher. Proven or probable invasive pulmonary aspergillosis (14.9%) and candidemia (6.2%) appear to be the two most frequent infections. “
Aspergillus is ubiquitous: we breathe three or four spores per cubic meter of air. In a normal situation, we eliminate them,
”says the researcher.
In the context of Covid patients with acute respiratory distress, the researchers identified three risk factors for the emergence of the infection: age (over 62 years), two anti-Covid drugs (dexamethasone associated with anti-IL6R) and mechanical ventilation for more than 15 days. “
There are aggravating factors linked to the
anti-Covid
treatment
”, explained the researcher. “
For a large majority of people, these are effective treatments that can treat the underlying disease. But these treatments sometimes promote the emergence of infections,
”explained Professor Gangneux. More studies will need to be done to determine whether early antifungal treatment or prophylaxis is needed, the researchers say.