1. Pneumocystis jirovecii Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience.
- Author
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Gentile I, Viceconte G, Lanzardo A, Zotta I, Zappulo E, Pinchera B, Scotto R, Schiano Moriello N, Foggia M, Giaccone A, Messina G, Salvatore P, Buonomo AR, and Federico Ii Covid-Team
- Subjects
- COVID-19 Testing, Humans, Immunocompromised Host, SARS-CoV-2, COVID-19, Pneumocystis carinii, Pneumonia, Pneumocystis drug therapy
- Abstract
Objective: to describe a single-center experience of Pneumocystis jirovecii pneumonia (PJP) in non-HIV patients recovering from COVID-19., Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital., Results: With the exception of one subject, who experienced an atypical and prolonged course of COVID-19, all the patients developed PJP after the clinical resolution of COVID-19 pneumonia. All but one patient had no pre-existing immunosuppressive conditions or other risk factors for PJP development at COVID-19 diagnosis. Nonetheless, following the course of COVID-19 infection, all the patients fulfilled at least one host factor for PJP; indeed, all the patients had received at least 2 weeks of high-dose steroids and three out of five had a CD4+ cell count <200/mm
3 ., Conclusions: The use of corticosteroids for COVID-19 respiratory impairment seems to be the most common risk factor for PJP, together with viral-induced and iatrogenic lymphopenia. The worsening in respiratory function and the characteristic radiological picture during or after COVID-19 pneumonia should raise the suspicion of PJP, even in immunocompetent patients. PJP primary chemoprophylaxis can be considered in selected high-risk COVID-19 patients, but further studies are needed.- Published
- 2021
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