Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS

Fernando Antonio Messina, Andrés Benchetrit, Andrea Bocassi, María de las Mercedes Romero, Sofía Bauer, Emmanuel Marín, Facundo Bertera, Guillermo Onis, Matías Enzenhofer, Milagro Sánchez, Lilia Mammana, Dana Mijalovsky, Gabriela Santiso, .

Keywords: COVID-19, SARS-Cov-2, Cryptococcus, meningitis, cryptococcal, coinfection, HIV infections

Abstract

Introduction. Fungal infections in patients with COVID-19 was one of the most debated topics during the pandemic.
Objectives. To analyze the clinical characteristics and evolution of people living with HIV/AIDS and coinfection with cryptococcus and COVID-19 (group A) or without it (group B).
Materials and methods. This is an analytical and retrospective study. We reviewed medical records of patients with meningeal cryptococcosis between April 2020 and May 2021.
Results. We studied 65 people living with HIV/AIDS and with cryptococcosis infection diagnosed from April 2020 to May 2021. Fifteen patients with HIV/AIDS suffered from cryptococcosis and COVID-19, and out of these, 14 presented meningitis (group A), while 28 suffered from meningeal cryptococcosis, but did not have COVID-19 (group B).
Conclusions. No statistically significant differences were observed between the two groups (A and B) considering: intracranial hypertension, presence of Cryptococcus antigens in cerebrospinal fluid, sensorium deterioration or mortality.
The detection of Cryptococcus antigens in serum by lateral flow assay was highly effective to rapidly diagnose cryptococcosis in patients with HIV/AIDS who also developed COVID-19. Patients of both groups consulted for cryptoccocosis sometime after, in comparison with the pre-pandemic cases related to this infection.

Downloads

Download data is not yet available.

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-33. https://doi.org/10.1056/NEJMoa2001017

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. https://doi.org/10.1016/S0140-6736(20)30183-5

Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91:157-60. https://doi.org/10.23750 /abm.v91i1.9397

Zhang H, Wu T. CD4+T, CD8+T counts and severe COVID-19: A meta-analysis. J Infect. 2020;81:e82-e4. https://doi.org/10.1016/j.jinf.2020.06.036

Ho HE, Peluso MJ, Margus C, Matias Lopes JP, He C, Gaisa MM, et al. Clinical outcomes and immunologic characteristics of coronavirus disease 2019 in people with human immunodeficiency virus. J Infect Dis. 2021;223:4038. https://doi.org/10.1093/infdis/jiaa380

Lee KW, Yap SF, Ngeow YF, Lye MS. COVID-19 in people living with HIV: A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18:3554. https://doi.org/10.3390/ijerph18073554

Pal R, Singh B, Bhadada SK, Banerjee M, Bhogal RS, Hage N, et al. COVID-19-associated mucormycosis: An updated systematic review of literature. Mycoses. 2021;64:1452-9. https://doi.org/10.1111/myc.13338

Kariyawasam RM, Dingle TC, Kula BE, Vandermeer B, Sligl WI, Schwartz IS. Defining COVID-19-associated pulmonary aspergillosis: Systematic review and meta-analysis. Clin Microbiol Infect. 2022;28:920-7. https://doi.org/10.1016/j.cmi.2022.01.027

Messina F, Marin E, Valerga M, Depardo R, Chediak V, Romero M et al. Updates on AIDS and infectology. Actualizaciones en Sida e Infectología. 2021;29:6-16. https://doi.org/10.52226/revista.v29i105.49

Khatib MY, Ahmed AA, Shaat SB, Mohamed AS, Nashwan AJ. Cryptococcemia in a patient with COVID-19: A case report. Clin Case Rep. 2020;9:853-5. https://doi.org/10.1002/ccr3.3668

Woldie IL, Brown IG, Nwadiaro NF, Patel A, Jarrar M, Quint E, et al. Autoimmune hemolytic anemia in a 24-year-old patient with COVID-19 complicated by secondary cryptococcemia and acute necrotizing encephalitis: A case report and review of literature. J Med Cases. 2020;11:362-5. https://doi.org/10.14740/jmc3575

Frías-De-León MG, Pinto-Almazán R, Hernández-Castro R, GarcíaSalazar E, Meza-Meneses P, Rodríguez-Cerdeira C, et al. Epidemiology of systemic mycoses in the COVID-19 pandemic. J Fungi (Basel). 2021;7:556. https://doi.org/10.3390/jof7070556

Arechavala A, Negroni R, Messina F, Romero M, Marín E, Depardo R, et al. Cryptococcosis in an infectious diseases hospital of Buenos Aires, Argentina. Revision of 2041 cases: Diagnosis, clinical features and therapeutics. Rev Iberoam Micol. 2018;35:1-10. https://doi.org/10.1016/j.riam.2017.04.003

Firacative C, Meyer W, Castañeda E. Cryptococcus neoformans and Cryptococcus gatti species complexes in Latin America: A map of molecular types, genotypic diversity, and antifungal susceptibility as reported by the Latin American Cryptococcal Study Group. J Fungi (Basel). 2021;7:282. https://doi.org/10.3390/jof7040282

Rajasingham R, Govender NP, Jordan A, Loyse A, Shroufi A, Denning DW, et al. The global burden of HIV-associated cryptococcal infection in adults in 2020: a modelling analysis. Lancet Infect Dis. 2022;22:1748-55. https://doi.org/10.1016/S1473-3099(22)00499-6

Guelfand L, Cataldi S, Arechavala A, Perrone M. Manual práctico de micología médica. Acta Bioquim Clin Latinoam. 2015; Supl. 1.

Arechavala AI, Robles AM, Negroni R, Bianchi MH, Taborda A. Value of direct and indirect diagnostic methods in systemic mycoses associated with AIDS. Rev Inst Med Trop Sao Paulo. 1993;35:163-9. https://doi.org/10.1590/s0036-46651993000200008

Huang HR, Fan LC, Rajbanshi B, Xu JF. Evaluation of a new cryptococcal antigen lateral flow immunoassay in serum, cerebrospinal fluid and urine for the diagnosis of cryptococcosis: A meta-analysis and systematic review. PLoS One. 2015;10:e0127117. https://doi.org/10.1371/journal.pone.0127117

IMMY. Immy CrAg lateral flow assay REF CR2003. Fecha de consulta: 05 de agosto del 2020. Disponible en: www.immy.com

Centers for Disease Control and Prevention. Cryptococcal screening a new strategy for saving lives among people with HIV/AIDS 11-10-2021. Fecha de consulta: 12 de octubre del 2020: Disponible en: https://www.cdc.gov/fungal/pdf/crypto-screen-strategy-508c.pdf

Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021;19:141-54. https://doi.org/10.1038/s41579-020-00459-7. Erratum in: Nat Rev Microbiol. 2022 May;20:315.

Messina FA, Maiolo E, Negroni R, Arechavala A, Santiso G, Bianchi M. Alternativas terapéuticas de la criptococosis meníngea. ASEI. 2015;23:2532.

Liu J, Li H, Luo M, Liu J, Wu L, Lin X, et al. Lymphopenia predicted illness severity and recovery in patients with COVID-19: A single-center, retrospective study. PLoS One. 2020;15:e0241659. https://doi.org/10.1371/journal.pone.0241659

Toori KU, Qureshi MA, Chaudhry A. Lymphopenia: A useful predictor of COVID-19 disease severity and mortality. Pak J Med Sci. 2021;37:1984-8. https://doi.org/10.12669/pjms.37.7.4085

Sayah W, Berkane I, Guermache I, Sabri M, Lakhal FZ, Yasmine Rahali S, et al. Interleukin-6, procalcitonin and neutrophil-to-lymphocyte ratio: Potential immuneinflammatory parameters to identify severe and fatal forms of COVID-19. Cytokine. 2021;141:155428. https://doi.org/10.1016/j.cyto.2021.155428

Regalla D, VanNatta M, Alam M, Malek AE. COVID-19-associated Cryptococcus infection (CACI): a review of literature and clinical pearls Infection. 2022;50:1-6. https://doi.org/10.1007/s15010-022-01805-y

How to Cite
1.
Messina FA, Benchetrit A, Bocassi A, Romero M de las M, Bauer S, Marín E, et al. Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS. biomedica [Internet]. 2023 Aug. 31 [cited 2024 May 19];43(Sp. 1):206-15. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/6872

Some similar items:

Published
2023-08-31

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code