Aspectos da COVID-19 como fatores de risco para a infecção ou reativação da coccidioidomicose: uma revisão sistemática
DOI:
https://doi.org/10.33448/rsd-v11i12.35062Palavras-chave:
Coccidioidomicose; Coccidioides spp.; COVID-19; Pós-COVID-19; Infecção Secundária; Doenças negligenciadas.Resumo
A coccidioidomicose é uma micose profunda causada por fungos dimórficos do gênero Coccidioides. As manifestações clínicas da infecção por Coccidioides spp. podem ser bastante diversificadas. A principal forma clínica da coccidioidomicose é a infecção respiratória cujos sinais e sintomas mais frequentes são tosse, dispneia, dor torácica, febre, artralgia, mialgia, fadiga e perda de peso. A coccidioidomicose pulmonar, especialmente na sua manifestação como pneumonia aguda, pode ser facilmente confundida com outras pneumopatias, incluindo a COVID-19. O objetivo desse trabalho é realizar uma revisão sistemática de casos de coccidioidomicose em pacientes com infecção pelo SARS-CoV-2 ou que desenvolveram essa micose no período posterior à COVID-19. O contexto da COVID-19 e seu tratamento com corticoesteriores podem facilitar a infecção por Coccidioides spp. ou a reativação de infecções latentes desse fungo. O principal risco à vida daqueles acometidos pela coccidioidomicose concomitante ou posterior à COVID-19 é o diagnóstico tardio. O uso de corticosteriodes no tratamento da COVID-19 e a diabetes são os fatores de risco mais relevantes para o desenvolvimento da infecção pelo Coccidioides spp. ou a reativação da infecção fúngica latente. Exames laboratoriais de biópsia e de cultivo de material das vias aéreas e lesões cutâneas, além de sorologia para diagnóstico da coccidioidomicose devem ser incorporados à rotina de avaliação de infecções secundárias na COVID-19 e pneumopatias subsequentes à infecção pelo SARS-CoV-2, especialmente em indivíduos mais susceptíveis nas regiões de alta endemicidade.
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