# Overview on the Prevalence of Fungal Infections, Immune Response, and Microbiome Role in COVID-19 Patients

## TL;DR

This review explores how fungal infections like aspergillosis and candidemia are common in severe COVID-19 patients and how immune responses and the microbiome may influence these infections.

## Contribution

The paper provides a comprehensive overview of fungal co-infections in severe COVID-19 and highlights the role of the microbiome in disease progression.

## Key findings

- Fungal co-infections are increasingly linked to severe illness and death in ICU COVID-19 patients.
- The microbiome may play a role in the immune response to fungal infections in these patients.
- Early diagnosis and treatment of fungal infections are crucial to prevent severe outcomes.

## Abstract

Patients with severe COVID-19, such as individuals in intensive care units (ICU), are exceptionally susceptible to bacterial and fungal infections. The most prevalent fungal infections are aspergillosis and candidemia. Nonetheless, other fungal species (for instance, Histoplasma spp., Rhizopus spp., Mucor spp., Cryptococcus spp.) have recently been increasingly linked to opportunistic fungal diseases in COVID-19 patients. These fungal co-infections are described with rising incidence, severe illness, and death that is associated with host immune response. Awareness of the high risks of the occurrence of fungal co-infections is crucial to downgrade any arrear in diagnosis and treatment to support the prevention of severe illness and death directly related to these infections. This review analyses the fungal infections, treatments, outcome, and immune response, considering the possible role of the microbiome in these patients. The search was performed in Medline (PubMed), using the words “fungal infections COVID-19”, between 2020–2021.