Pneumocystis pneumonia in COVID-19 patients: A comprehensive review

Elahe Sasani; Fares Bahrami; Mohammadreza Salehi; Farzad Aala; Ronak Bakhtiari; Alireza Abdollahi; Bahareh Bashardoust; Mahsa Abdorahimi; Sadegh Khodavaisy

doi:10.1016/j.heliyon.2023.e13618

Pneumocystis pneumonia in COVID-19 patients: A comprehensive review

Heliyon. 2023 Feb;9(2):e13618. doi: 10.1016/j.heliyon.2023.e13618. Epub 2023 Feb 10.

Authors

Elahe Sasani¹, Fares Bahrami^{2

3}, Mohammadreza Salehi^{4

5}, Farzad Aala³, Ronak Bakhtiari⁶, Alireza Abdollahi⁷, Bahareh Bashardoust⁸, Mahsa Abdorahimi⁹, Sadegh Khodavaisy^{2

4

8}

Affiliations

¹ Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
² Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
³ Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
⁴ Research center for antibiotic stewardship and antimicrobial resistance, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁹ Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran.

Abstract

The admitted patients of intensive care units with coronavirus disease 2019 (COVID-19) meet the challenges of subsequent infections. Opportunistic fungal infections such as Pneumocystis pneumonia (PCP) are among the important factors in the context of COVID-19 patients affecting illness severity and mortality. We reviewed the literature on COVID-19 patients with PCP to identify features of this infection. Although studies confirmed at least the presence of one immunosuppressive condition in half of PCP patients, this disease can also occur in immunocompetent patients who developed the immunosuppressive condition during Covid-19 treatment. The major risk factors associated with COVID-19 patients with PCP can be considered low lymphocyte counts and corticosteroid therapy. Diagnostic and treatment options are complicated by the overlapping clinical and radiologic characteristics of PCP and COVID-19 pneumonia. Therefore, physicians should comprehensively evaluate high-risk patients for PCP prophylaxis.

Keywords: COVID-19; Pneumocystosis pneumonia; SARS-CoV-2.