Mucormycosis: A Lethal Phenomenon in COVID-19 Patients: A Review of Diagnostic and Therapeutic Approaches

Coronavirus disease 2019 (COVID-19) has seriously spread worldwide. One of the problems of COVID-19 patients is co-infection with other microbial infections such as fungal infections that are severely life-threatening. Mucormycosis, one of these opportunistic fungal diseases that is mistakenly known as black fungal disease, has been reported in Iran and the world. This non-systematic review is intended to review the latest studies in the world and Iran about the incidence of mucormycosis in COVID-19 patients to better understand the disease and its predisposing factors. In general, patients with COVID-19 with underlying diseases, diabetic patients, those treated with immunosuppressive drugs, ICU patients, and patients under invasive mechanical ventilation are at higher risk for mucormycosis. Therefore, early diagnosis, treatment, and prevention methods can be effective in reducing the risk of mucormycosis in COVID-19 patients

Invasive Aspergillosis in COVID-19: A Review Study and Recommendations for Diagnostic Approaches

Background and purpose: COVID-19 is an emerging viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Bacterial or fungal superinfections of the lung may cause complications in clinical manifestations, treatment, and increase the mortality rate. In this article, we reviewed previous studies on invasive aspergillosis (IA) in viral infections and in adjustment with COVID-19. Also, the necessity of IA diagnosis to increase the survival rate in involved patients is discussed. Materials and methods: Electronic databases, including Pubmed, Google Scholar, and Web of Science were searched using the following keywords: COVID-19, SARS-CoV-2, influenza, invasive aspergillosis, and invasive fungal infections. Results: Reports from China showed 3.2% to 27.1% fungal co-infection in COVID-19 patients. Patients with COVID-19 who developed severe pneumonia were found with considerably higher rates of viral, bacterial, and fungal co-infections than those with mild pneumonia. Also, intestinal normal fungal flora was reported to be significantly different between COVID-19 patients and normal subjects. Conclusion: While the main focus of physicians is on bacterial superinfection control in COVID-19, ignoring life threatening fungal infections may increase the mortality rate. Therefore, we profoundly recommend early diagnosis of invasive fungal infections in COVID-19 patients

The effect of nanochitosans particles on Candida biofilm formation

Background and Purpose: In people wearing dentures, the growth of various Candida species under the prosthesis leads to the formation of biofilm, which can play the role of a reservoir for Candida and other kinds of microbes. Since nano-chitosan particles can cause lasting antimicrobial activity, a more recent approach that utilizes acrylic resins with nano-chitosan particles is proposed. Therefore, we aimed to study the inhibitory effect of nano-chitosan particles on the biofilm formation of Candida species in acrylic resins. Materials and Methods: In this analytical in-vitro study, acrylic resins with nano-chitosan particles with concentrations of 0, 1%, 5%, and 10% were put adjacent to the suspension of Candida cells isolated from the individuals&rsquo; mouth and biofilm formation on resins was measured and compared. Finally, the data were analyzed using Kruskal-Wallis and Chi-square tests. Results:The observed differences between unmodified acrylic resin (control) and acrylic resin with nano-chitosan particles in terms of biofilm formation were significant (P<0.05), but no significant difference was found in the formation of biofilm species on resins. Conclusion: Biofilm formation of Candida species depends on acrylic resin type, in a way that by adding nano-chitosan particles to acrylic resins, biofilm formation of Candida species was significantly reduced. To decrease the organization of biofilm and denture stomatitis, the use of acrylics with nano-chitosan particles in producing dentures is recommended