COVID-۱۹-associated fungal infections in Iran: a systematicreview

Background and Aim : Following the COVID-۱۹ spread in Iran, cases of CAFIs have beenreported from different parts of the country [۱۴-۱۶]. To date, there is no comprehensive study offungal infections in patients with COVID-۱۹ in Iran. In this systematic review, we aim tosummarize the studies that have reported COVID-۱۹-associated fungal infections (CAFIs) in Iran.Methods : PubMed, Web of Science, Scopus, Cochrane Library, SID, Magiran, IranDoc, andGoogle Scholar were searched for Persian and English articles published from January ۱, ۲۰۲۰, toNovember ۵, ۲۰۲۱, using a systematic search strategy. Studies on Iranian patients suffering fromCAFIs were included in the review.Results : Twenty-two studies comprising ۱۶۹ patients were retrieved. Reported CAFIs includedcandidiasis (۸۵, ۵۰.۳۰%), mucormycosis (۳۵, ۲۰.۷۱%), aspergillosis (۲۹, ۱۷.۱۶%), fusariosis (۶,۳.۵۵%), three cases caused by rare pathogens (Rhodotorula mucilaginosa, Diaporthe foeniculina,and Sarocladium kiliense) and ۱۱ (۶.۵۱%) uncharacterized mold infections. The most commonunderlying diseases were diabetes (۶۷/۱۶۸, ۳۹.۸۸%), cardiovascular diseases (۵۵/۱۶۸, ۳۲.۷۴%),and hypertension (۴۳/۱۶۸, ۲۵.۵۹%). The use of antibiotics (۱۱۱/۱۲۴, ۸۹.۵۲%), corticosteroids(۹۳/۱۳۲, ۷۰.۴۴%), and mechanical ventilation (۶۶, ۵۱.۱۶%) were the most common predisposingfactors. Totally, ۷۲ (۵۰.۳۵%) of ۱۴۳ patients with CAFIs died (data were not available for ۲۶patients).Conclusion : Fungal infections are evident to be a complication of COVID-۱۹ in Iran; thus,clinicians should consider them as a differential diagnosis, especially in patients withcomorbidities and previous antibiotic or corticosteroid use.

کلیدواژه ها:

COVID-۱۹ ، mycoses ، candidiasis ، mucormycosis ، aspergillosis ، fusariosis ، Iran