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dc.contributor.authorAlanio, Alexandre et al.
dc.description.abstractWe are currently facing a frightening increase in COVID-19 patients admitted to the ICU. Aiming at screening for secondary pneumonia, we collected the data of our first twelve ICU patients who underwent bronchoalveolar lavage (BAL). Surprisingly, four were detected with Pneumocystis jirovecii (Pj) DNA and RNA, resulting in Pj prevalence of 17%. Pj is a ubiquitous ascomycetes fungus that thrives at the surface of type-I pneumocytes, specifically in human alveoli, leading to pneumocystosis in immunocompromised patients. Interestingly, none of our patients was immunocompromised per se before admission, while all presented the recognized risk factors for life-threatening COVID-19 infection. Observing such high prevalence in COVID-infected patients was unexpected. Almost all patients developed ARDS and received high-dose steroids to prevent worsening, as suggested by reports from China. In Pj-positive patients requiring steroids, prophylaxis was given to avoid the risk of pneumocystosis and increased lung inflammation that may compromise the outcome. We are strongly convinced that testing deep lung specimens for Pj in severe COVID-19 patients should be recommended and Pj-positive patients treated with steroids, and given anti-Pj prophylaxis. This message is important, given the high mortality rate of COVID-19 patients in the ICU.en_US
dc.subjectInfectious Diseasesen_US
dc.subjectIntensive Care Units, Neonatalen_US
dc.subjectPneumocystis cariniien_US
dc.subjectRespiratory Distress Syndrome, Adulten_US
dc.titleDo COVID-19 patients admitted to the ICU require anti-Pneumocystis jirovecii prophylaxis?en_US
eihealth.countryGlobal (WHO/OMS)en_US
eihealth.categoryClinical characterization and managementen_US
eihealth.typePublished Articleen_US
eihealth.maincategorySave Lives / Salvar Vidasen_US

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