Corticosteroid therapy associated with COVID-19 : an ally or a risk factor for the establishment of secondary fungal co-infections?

• Autor(a) principal: Amaral, Thaís Ferreira do
• Data de Publicação: 2022
• Outros Autores: Coutinho, Natália Monteiro da Silva Rodrigues, Fuentefria, Rubia do Nascimento, Fuentefria, Alexandre Meneghello, Machado, Gabriella da Rosa Monte
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/270831
• topic: Corticosteróides; Efeitos adversos; COVID-19; Tratamento farmacológico da COVID-19; Aspergilose; Coinfecção; Mucormicose; Fungal co-infections; Mucormycosis; Aspergillosis; Corticotherapy

Corticosteroid therapy to combat inflammation caused by SARS-CoV-2 seems to be a risk factor for developing secondary fungal co-infections. PubMed and ScienceDirect databases were searched, with the following word groups: [(aspergillosis OR mucormycosis OR candidiasis) AND (coronavirus disease) AND (corticoids). The selected articles present the main risk factors related to the establishment of secondary fungal co-infections in COVID-19 patients. Corticosteroid therapy used to combat inflammation caused by SARS-CoV-2 has been shown to be strongly associated with the establishment of mucormycosis and aspergillosis. Mucormycosis has been the main fungal co-infection related to corticosteroid therapy, causing a high number of deaths in COVID-19 patients. Diabetes mellitus was the most prevalent comorbidity, especially for the establishment of mucormycosis. Dexamethasone use seems to be associated with mucormycosis emergence and death. However, aspergillosis showed a greater relationship with patient recovery. Thus, risk factors such as diabetes mellitus, combined with corticosteroid use, have shown a relationship to the establishment of mucormycosis. The corticosteroids used in COVID-19 patients should be individually analyzed, considering the patient’s medical history and the risk/benefit ratio of the use of these drugs.