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Review
. 2022 Mar 14;79(5):127.
doi: 10.1007/s00284-022-02824-6.

COVID-19-Associated Candidiasis: Possible Patho-Mechanism, Predisposing Factors, and Prevention Strategies

Nafisa Ahmed #  1 , Maiesha Samiha Mahmood #  1 , Md Asad Ullah  2 , Yusha Araf  3 , Tanjim Ishraq Rahaman  4 , Abu Tayab Moin  5 , Mohammad Jakir Hosen  6
Affiliations
Review

COVID-19-Associated Candidiasis: Possible Patho-Mechanism, Predisposing Factors, and Prevention Strategies

Nafisa Ahmed et al. Curr Microbiol. .

Abstract

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is threatening public health. A large number of affected people need to be hospitalized. Immunocompromised patients and ICU-admitted patients are predisposed to further bacterial and fungal infections, making patient outcomes more critical. Among them, COVID-19-associated candidiasis is becoming more widely recognized as a part of severe COVID-19 sequelae. While the molecular pathophysiology is not fully understood, some factors, including a compromised immune system, iron and zinc deficiencies, and nosocomial and iatrogenic transmissions, predispose COVID-19 patients to candidiasis. In this review, we discuss the existing knowledge of the virulence characteristics of Candida spp. and summarize the key concepts in the possible molecular pathogenesis. We analyze the predisposing factors that make COVID-19 patients more susceptible to candidiasis and the preventive measures which will provide valuable insights to guide the effective prevention of candidiasis in COVID-19 patients.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Molecular pathogenesis of Candida spp. (1 and 2) Planktonic Candida spp. cells express adhesins that facilitate attachment to host cell surfaces. (3) Environmental stimuli and induce morphology-associated genes and thigmotropism stimulate the transition from yeast-to-hypha transition and hyphal-directed growth. (4) Some Candida spp. exhibit phenotype switching, i.e., the epigenetic switching from white to opaque cells. (5) The two routes of Candida spp. invasion are as follows: (5A) Induced endocytosis where the fungal cells are engulfed by the host cell and (5B) Active penetration where the fungal hydrolases mediate host tissue penetration. (6) Some Candida spp. form biofilms upon the attachment to both biotic and abiotic surfaces. When Candida spp. enters the bloodstream, they are disseminated to vital organs, causing disseminated candidiasis. The genes involved in virulence are listed along with the corresponding steps in the pathogenesis
Fig. 2
Fig. 2
The factors that predispose COVID-19 patients to candidiasis and the possible mechanism involved
See this image and copyright information in PMC

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