Description of Cryptococcosis Following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Disease Survey Through the Mycosis Study Group Education and Research Consortium (MSG-19)
Author:
Walker Jeremey1, McCarty Todd1, McGwin Gerald1, Ordaya Eloy E2, Vergidis Paschalis2, Ostrosky-Zeichner Luis3, Mammadova Mehriban3, Spec Andrej4, Rauseo Adriana M4, Perfect John5, Messina Julia5, Vilchez Gabriel6, McMullen Rachel1, Jones Carolynn T7ORCID, Pappas Peter G1, Yetmar Zachary, Masayuki Nigo, Steinbrink Julie, Cahuayme-Zuniga Lizbeth, Vootukuri Shobha, Onyeaghala Chizaram, Ta Tuan V, Kale Pratibha, Franklin Alexander, Gandhi Ravi, Ostrander Darin, Miceli Marisa, Warner Nathaniel, Thomas Lora, Obeid Karam, Hoz Ricardo M La, Sochanska Ada, Klausing Benjamin, El-Herte Rima, Tirmizi Amir, Traver Edward C, Thompson George R, Gorsline Chelsea, Sivasubramanian Geetha, Osborn Rebecca, Mounajjed Mark,
Affiliation:
1. University of Alabama at Birmingham, School of Medicine , Birmingham, Alabama , USA 2. Mayo Clinic, Infectious Diseases , Rochester, Minnesota , USA 3. University of Texas Health Sciences Center, Infectious Disease , Houston, Texas , USA 4. Washington University, Division of Infectious Diseases , St Louis, Missouri , USA 5. Duke University, Infectious Diseases , Durham, North Carolina , USA 6. University of Kentucky, College of Medicine , Lexington, Kentucky , USA 7. The Ohio State University, College of Nursing , Columbus, Ohio , USA
Abstract
Abstract
Background
Invasive fungal infections have been described throughout the COVID-19 pandemic. Cryptococcal disease after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in several isolated case reports and 1 larger case series. We sought to describe cryptococcal infections following SARS-CoV-2 through establishing a database to investigate underlying risk factors, disease manifestations, and outcomes.
Methods
We created a crowdsourced call for cases solicited through the Mycoses Study Group Education and Research Consortium, the Centers for Disease Control and Prevention Emerging Infectious Diseases Network, and infectious diseases Twitter groups. Data were collected in a web-based and secure REDCap survey without personal identifiers.
Results
Sixty-nine cases were identified and submitted by 29 separate institutional sites. Cryptococcosis was diagnosed a median of 22 days (interquartile range, 9–42 days) after SARS-CoV-2 infection. Mortality among those with available follow-up was 72% (26/36) for the immunocompetent group and 48% (15/31) for the immunocompromised group (likelihood ratio, 4.01; P = .045). We observed a correlation between disease manifestation (central nervous system infection, proven/probable disseminated disease, and respiratory) and mortality (P = .002).
Conclusions
The mortality rate of 59% for patients with cryptococcosis following SARS-CoV-2 is higher than that of modern Cryptococcus cohorts. There was an association between immunocompromised status and cryptococcal disease manifestations as well as mortality. Moreover, our series emphasizes the need for clinical and laboratory assessment of opportunistic infections beyond 30 days when concerning symptoms develop.
Funder
Department of Health and Human Services
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
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