Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 08, 2026 20 minutes ago
Fungal infections emerging alongside COVID-19 can dramatically complicate severe disease, particularly among critically ill patients, according to a major new scientific review examining the mechanisms, diagnosis, risk factors, and treatment of these potentially deadly co-infections.
Researchers warn that invasive fungal infections can exploit COVID-19-related immune dysfunction and tissue
damage, potentially worsening outcomes in critically ill patients
Researchers reviewed evidence involving Aspergillus, Candida, Mucorales, Cryptococcus, and Pneumocystis, finding that SARS-CoV-2 can create conditions that allow opportunistic fungi to invade damaged tissues.
Researchers Span Nine Institutions
The researchers are from Jagannath University, North South University, Shahjalal University of Science and Technology, King Faisal University, Prince Sattam Bin Abdulaziz University, Beni-Suef University, Shimane University, the University of Florida, and Yeungnam University, representing Bangladesh, Saudi Arabia, Egypt, Japan, the United States, and South Korea.
COVID-19 Creates an Opening for Fungi
This
Thailand Medical News report highlights how COVID-19 can disrupt epithelial barriers and dysregulate immune defenses, providing fungi with opportunities to establish invasive infections.
The review found that patients requiring mechanical ventilation, people with diabetes, individuals with neutropenia, and those with weakened immune systems face particularly elevated risks. Corticosteroids and other immunosuppressive treatments may further increase vulnerability.
Importantly, the authors report that bacterial and fungal co-infections have been associated with more than double the risk of death in COVID-19 patients. Candida albicans accounted for approximately 75% of reported candidiasis cases, although non-albicans Candida species are becoming increasingly clinically important.
Evidence reviewed also showed striking differences between patient groups and locations. Among ventilated ICU patients, individual studies reported substantial fungal infection burdens, while invasive fungal infections in COVID-19 patients have been associated with mortality ranging from 40.25% to 71.4%.
Faster Diagnosis Could Save Lives
One major problem is distinguishing harmless fungal colonization from true invasive disease. Available approaches include microscopy, histopathology, cultures, CT imaging, fungal biomarkers, and molecular testing.
Galactomannan testing of bronchoalveolar lavage fluid achieved 100% sensitivity and 76.2% specificity in evidence reviewed, while multiplex PCR for Candida reached 97.81% specificity. MALDI-TOF mass spectrometry could identify C. albicans from positive blood cultures in about 30 minutes, with 95.9% sensitivity.
Treatment must be matched to the pathogen. Five major antifungal classes are available, including polyenes, azoles, echinocandins, allylamines, and antimetabolites. Liposomal amphotericin B remains a first-line treatment for COV
ID-19-associated mucormycosis.
Conclusions
The findings underline that fungal co-infections remain a serious complication of COVID-19, requiring earlier recognition, standardized diagnostic criteria, carefully targeted antifungal therapy, resistance surveillance, and further research into biomarkers and new treatments.
The study findings were published in the peer reviewed Journal of Clinical Medicine.
https://www.mdpi.com/2077-0383/15/17/6896
Read Also:
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/articles/long-covid
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