Title:Glucocorticoids, COVID-19 and Cryptococcosis
Volume: 22
Issue: 2
Author(s): Wanessa Maria dos Santos and Alexandre Paula Rogerio*
Affiliation:
- Departamento de Biomedicina, Laboratory of Experimental Immunopharmacology, Universidade Federal of
Triângulo Mineiro, Rua Manoel Carlos, 162. 38025-380, Uberaba, MG, Brazil
Keywords:
Glucocorticoids, COVID-19, cryptococcosis, co-infections, susceptibility, superinfectious.
Abstract: Cryptococcus neoformans and C. gattii pneumonitis could persist asymptomatically for
indefinite periods, resolve, or progress to symptomatic dissemination, mainly in immunocompromised
individuals (e.g., treated with corticosteroids). The symptoms of COVID-19 may range from
a self-limiting illness with general symptoms, such as fever, to more severe complications, such as
pneumonitis. The glucocorticoids emerged as potential for treatment of COVID-19, mainly those
patients who required ventilator therapy. However, although treatment with glucocorticoids has
shown benefits in patients with COVID-19, they can be dangerous due to increased risk of coinfections
and superinfections caused by opportunistic pathogens such as Cryptococcus ssp. Some
patients with severe COVID-19 pneumonia treated with glucocorticoids developed cryptococcal infection
and died. Therefore, immunomodulatory therapy could increase the susceptibility to acute
infection or reactivation of Cryptococcus ssp in COVID-19 patients, and this could be complicated
once pulmonary cryptococcosis has symptoms similar to COVID-19 becomes difficult to distinguish
between the two disease states and treatment.
