{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:16:50Z","timestamp":1791245810549,"version":"4.1.0"},"reference-count":136,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003819","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003819","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>Secondary fungal infections are increasingly recognized as critical factors in the prognosis of severe acute viral infections, including influenza, SARS-CoV-2, Severe Fever with Thrombocytopenia Syndrome virus, and Dengue. This review outlines the clinical features of fungal complications, proposing a \u201cvirus-driven immune reprogramming\u201d framework. It highlights how viral infections disrupt immune barriers, impair the Th17-IL-17 antifungal axis, attenuate platelet immune function, and involve unique pathogen interactions, creating a host immune microenvironment that is more susceptible to fungal invasion. Understanding these immune-injury mechanisms underscores the clinical importance of earlier surveillance of secondary fungal disease and informs the development of mechanism-guided therapeutic approaches to improve patient outcomes.<\/jats:p>","DOI":"10.3389\/fmicb.2026.1780547","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:42:35Z","timestamp":1772779355000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Secondary fungal infections in severe acute viral diseases: clinical features and underlying immune mechanisms"],"prefix":"10.3389","volume":"17","author":[{"given":"Hanxin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiandan","family":"Xiang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/cei.12747","article-title":"Dengue NS1 antigen contributes to disease severity by inducing interleukin (IL)-10 by monocytes.","volume":"184","author":"Adikari","year":"2016","journal-title":"Clin. Exp. Immunol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1111\/myc.13256","article-title":"The double-edged sword of systemic corticosteroid therapy in viral pneumonia: a case report and comparative review of influenza-associated mucormycosis versus COVID-19 associated mucormycosis.","volume":"64","author":"Ahmadikia","year":"2021","journal-title":"Mycoses"},{"key":"B3","doi-asserted-by":"publisher","first-page":"7475","DOI":"10.2147\/IJGM.S382687","article-title":"Incidence of bacterial and fungal secondary infections in COVID-19 patients admitted to the ICU.","volume":"15","author":"Alshrefy","year":"2022","journal-title":"Int. J. Gen. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1111\/j.1600-6143.2010.03094.x","article-title":"Exogenous interferon-gamma immunotherapy for invasive fungal infections in kidney transplant patients.","volume":"10","author":"Armstrong-James","year":"2010","journal-title":"Am. J. Transplant."},{"key":"B5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3389\/fmicb.2014.00337","article-title":"Modulation of dendritic cell functions by viral IL-10 encoded by human cytomegalovirus.","volume":"5","author":"Avdic","year":"2014","journal-title":"Front. Microbiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1103226","DOI":"10.3389\/fcimb.2022.1103226","article-title":"Multiple Candida strains causing oral infection in COVID-19 patients under corticosteroids and antibiotic therapy: an observational study.","volume":"12","author":"Babamahmoodi","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1093\/cid\/ciz673","article-title":"Invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome.","volume":"70","author":"Bae","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.ijid.2022.05.005","article-title":"COVID-19-associated mucormycosis: an opportunistic fungal infection. A Case Series and Review.","volume":"121","author":"Balushi","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3390\/jof8010058","article-title":"Fungal infections other than invasive aspergillosis in COVID-19 Patients.","volume":"8","author":"Basile","year":"2022","journal-title":"J. Fungi"},{"key":"B10","doi-asserted-by":"publisher","first-page":"315","DOI":"10.3390\/jof9030315","article-title":"Pulmonary aspergillosis in critically Ill COVID-19 patients admitted to the intensive care unit: a retrospective cohort study.","volume":"9","author":"Bergmann","year":"2023","journal-title":"J. Fungi"},{"key":"B11","doi-asserted-by":"publisher","first-page":"5906","DOI":"10.4049\/jimmunol.1302992","article-title":"Lymphopenia associated with highly virulent H5N1 virus infection due to plasmacytoid dendritic cell\u2013mediated apoptosis of T cells.","volume":"192","author":"Boonnak","year":"2014","journal-title":"J. Immunol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/978-1-4471-6416-6_37","article-title":"Life threatening tropical infections.","volume":"2","author":"Botez","year":"2014","journal-title":"Pediatr. Crit. Care Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e84790","DOI":"10.7554\/eLife.84790","article-title":"SARS-CoV-2 uses CD4 to infect T helper lymphocytes.","volume":"12","author":"Brunetti","year":"2023","journal-title":"Elife"},{"key":"B14","doi-asserted-by":"publisher","first-page":"ofab016","DOI":"10.1093\/ofid\/ofab016","article-title":"Opportunistic fungal infection associated with COVID-19.","volume":"8","author":"Cafardi","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1146\/annurev-immunol-101220-034306","article-title":"Immunity to invasive fungal diseases.","volume":"40","author":"Casadevall","year":"2022","journal-title":"Annu. Rev. Immunol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"S103","DOI":"10.1016\/S0924-8579(08)70009-8","article-title":"Epidemiology of invasive fungal infection.","volume":"32","author":"Cast\u00f3n-Osorio","year":"2008","journal-title":"Int. J. Antimicrob. Agents"},{"key":"B17","doi-asserted-by":"publisher","first-page":"86","DOI":"10.3390\/jof9010086","article-title":"Invasive fungal infections in hospitalized patients with COVID-19: a non-intensive care single-centre experience during the first pandemic waves.","volume":"9","author":"Cattaneo","year":"2023","journal-title":"J. Fungi"},{"key":"B18","doi-asserted-by":"publisher","first-page":"108284","DOI":"10.1016\/j.jdiacomp.2022.108284","article-title":"COVID-19-associated Mucormycosis: a clinico-epidemiological study.","volume":"36","author":"Chakravarty","year":"2022","journal-title":"J. Diabetes Complicat."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.3390\/jof8101111","article-title":"COVID-19 associated with cryptococcosis: a new challenge during the pandemic.","volume":"8","author":"Chan","year":"2022","journal-title":"J. Fungi"},{"key":"B20","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.virol.2009.05.013","article-title":"Human cytomegalovirus suppresses type I interferon secretion by plasmacytoid dendritic cells through its interleukin 10 homolog.","volume":"390","author":"Chang","year":"2009","journal-title":"Virology"},{"key":"B21","doi-asserted-by":"publisher","first-page":"8720","DOI":"10.1128\/JVI.78.16.8720-8731.2004","article-title":"Human cytomegalovirus-encoded interleukin-10 homolog inhibits maturation of dendritic cells and alters their functionality.","volume":"78","author":"Chang","year":"2004","journal-title":"J. Virol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1111\/myc.13476","article-title":"Cryptococcosis among hospitalised patients with COVID-19: a multicentre research network study.","volume":"65","author":"Chastain","year":"2022","journal-title":"Mycoses"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.4049\/jimmunol.1201976","article-title":"Anti-dengue virus nonstructural protein 1 antibodies cause NO-mediated endothelial cell apoptosis via ceramide-regulated glycogen synthase kinase-3\u03b2 and NF-\u03baB activation.","volume":"191","author":"Chen","year":"2013","journal-title":"J. Immunol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2620","DOI":"10.1172\/JCI137244","article-title":"Clinical and immunological features of severe and moderate coronavirus disease 2019.","volume":"130","author":"Chen","year":"2020","journal-title":"J. Clin. Invest."},{"key":"B25","doi-asserted-by":"publisher","first-page":"130","DOI":"10.3389\/fimmu.2019.00130","article-title":"First case of patient with two homozygous mutations in MYD88 and CARD9 genes presenting with pyogenic bacterial infections. Elevated IgE, and Persistent EBV Viremia.","volume":"10","author":"Chiriaco","year":"2019","journal-title":"Front. Immunol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1038\/s41564-018-0329-x","article-title":"Severe fever with thrombocytopenia syndrome phlebovirus non-structural protein activates TPL2 signalling pathway for viral immunopathogenesis.","volume":"4","author":"Choi","year":"2019","journal-title":"Nat. Microbiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.jhin.2021.04.012","article-title":"Incidence, diagnosis and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA): a systematic review.","volume":"113","author":"Chong","year":"2021","journal-title":"J. Hosp. Infect."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s15010-021-01630-9","article-title":"Narrative review of the relationship between COVID-19 and PJP: does it represent coinfection or colonization?","volume":"49","author":"Chong","year":"2021","journal-title":"Infection"},{"key":"B29","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s15010-021-01701-x","article-title":"Comparing the clinical characteristics and outcomes of COVID-19-associate pulmonary aspergillosis (CAPA): a systematic review and meta-analysis.","volume":"50","author":"Chong","year":"2022","journal-title":"Infection"},{"key":"B30","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1046\/j.1365-2249.2000.01382.x","article-title":"Role of IL-10 in invasive aspergillosis: increased resistance of IL-10 gene knockout mice to lethal systemic aspergillosis.","volume":"122","author":"Clemons","year":"2000","journal-title":"Clin. Exp. Immunol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/CCM.0000000000004861","article-title":"The extent of aspergillosis in critically Ill patients with severe influenza pneumonia: a multicenter cohort study.","volume":"49","author":"Coste","year":"2021","journal-title":"Crit. Care Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e65212","DOI":"10.7759\/cureus.65212","article-title":"Mucormycosis in an immunocompetent patient recovering from dengue fever.","volume":"16","author":"D J","year":"2024","journal-title":"Cureus"},{"key":"B33","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1172\/JCI82224","article-title":"Sepsis-induced immune dysfunction: can immune therapies reduce mortality?","volume":"126","author":"Delano","year":"2016","journal-title":"J. Clin. Invest."},{"key":"B34","doi-asserted-by":"publisher","first-page":"827","DOI":"10.3389\/fimmu.2020.00827","article-title":"Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19).","volume":"11","author":"Diao","year":"2020","journal-title":"Front. Immunol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1836","DOI":"10.3389\/fimmu.2018.01836","article-title":"Human CARD9: a critical molecule of fungal immune surveillance.","volume":"9","author":"Drummond","year":"2018","journal-title":"Front. Immunol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"602732","DOI":"10.3389\/fmed.2020.602732","article-title":"Severe influenza with invasive pulmonary aspergillosis in immunocompetent hosts: a retrospective cohort study.","volume":"7","author":"Duan","year":"2020","journal-title":"Front. Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1556\/2060.2022.00015","article-title":"Co-infections in COVID-19 patients and correlation with mortality rate. Minireview.","volume":"109","author":"Feh\u00e9r","year":"2022","journal-title":"Physiol. Int."},{"key":"B38","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1016\/S2213-2600(24)00151-6","article-title":"Influenza-associated and COVID-19-associated pulmonary aspergillosis in critically ill patients.","volume":"12","author":"Feys","year":"2024","journal-title":"Lancet Respir. Med."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1016\/S2213-2600(22)00259-4","article-title":"Lung epithelial and myeloid innate immunity in influenza-associated or COVID-19-associated pulmonary aspergillosis: an observational study.","volume":"10","author":"Feys","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"5933","DOI":"10.1002\/jmv.28093","article-title":"Coinfections in hospitalized patients with severe fever with thrombocytopenia syndrome: a retrospective study.","volume":"94","author":"Ge","year":"2022","journal-title":"J. Med. Virol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"eaaw1327","DOI":"10.1126\/sciadv.aaw1327","article-title":"Anti-CotH3 antibodies protect mice from mucormycosis by prevention of invasion and augmenting opsonophagocytosis.","volume":"5","author":"Gebremariam","year":"2019","journal-title":"Sci. Adv."},{"key":"B42","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1172\/JCI71349","article-title":"CotH3 mediates fungal invasion of host cells during mucormycosis.","volume":"124","author":"Gebremariam","year":"2014","journal-title":"J. Clin. Invest."},{"key":"B43","doi-asserted-by":"publisher","first-page":"5597473","DOI":"10.1155\/2021\/5597473","article-title":"Cryptococcus neoformans meningoencephalitis in an immunocompetent patient after COVID-19 infection.","volume":"2021","author":"Ghanem","year":"2021","journal-title":"Case Rep. Infect. Dis."},{"key":"B44","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/S2213-2600(23)00408-3","article-title":"Risk factors for COVID-19-associated pulmonary aspergillosis: a systematic review and meta-analysis.","volume":"12","author":"Gioia","year":"2024","journal-title":"Lancet Respir. Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"633047","DOI":"10.3389\/fmicb.2021.633047","article-title":"Role for IL-1 family cytokines in fungal infections.","volume":"12","author":"Griffiths","year":"2021","journal-title":"Front. Microbiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"eads7369","DOI":"10.1126\/scitranslmed.ads7369","article-title":"A humanized antibody against mucormycosis targets angioinvasion and augments the host immune response.","volume":"17","author":"Gu","year":"2025","journal-title":"Sci. Transl. Med."},{"key":"B47","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.immuni.2011.02.006","article-title":"Type I interferon inhibits interleukin-1 production and inflammasome activation.","volume":"34","author":"Guarda","year":"2011","journal-title":"Immunity"},{"key":"B48","doi-asserted-by":"publisher","first-page":"134","DOI":"10.4103\/0974-2727.163137","article-title":"Concomitant infections of influenza A H1N1 and disseminated cryptococcosis in an HIV seropositive patient.","volume":"7","author":"Gupta","year":"2015","journal-title":"J. Lab Phys."},{"key":"B49","doi-asserted-by":"publisher","first-page":"e0154125","DOI":"10.1128\/mbio.01541-25","article-title":"Unveiling immune interference: how the dendritic cell response to co-infection with Aspergillus fumigatus is modulated by human cytomegalovirus and its virokine CMVIL-10.","volume":"16","author":"Heilig","year":"2025","journal-title":"mBio"},{"key":"B50","doi-asserted-by":"publisher","first-page":"bcr1120115224","DOI":"10.1136\/bcr.11.2011.5224","article-title":"Cryptococccal meningoencephalitis after H1N1 influenza.","volume":"2012","author":"Hosseinnezhad","year":"2012","journal-title":"BMJ Case Rep."},{"key":"B51","doi-asserted-by":"publisher","first-page":"16045","DOI":"10.1038\/nrdp.2016.45","article-title":"Sepsis and septic shock.","volume":"2","author":"Hotchkiss","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"B52","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1038\/nri3552","article-title":"Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy.","volume":"13","author":"Hotchkiss","year":"2013","journal-title":"Nat. Rev. Immunol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"576640","DOI":"10.3389\/fimmu.2021.576640","article-title":"Early-warning immune predictors for invasive pulmonary aspergillosis in severe patients with severe fever with thrombocytopenia syndrome.","volume":"12","author":"Hu","year":"2021","journal-title":"Front. Immunol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1693567","DOI":"10.3389\/fcimb.2025.1693567","article-title":"Pathogen profile of co-infections and mortality determinants among patients with severe fever with thrombocytopenia syndrome.","volume":"15","author":"Hu","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"e15544","DOI":"10.1097\/MD.0000000000015544","article-title":"Concomitant severe influenza and cryptococcal infections: a case report and literature review.","volume":"98","author":"Huang","year":"2019","journal-title":"Medicine"},{"key":"B56","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.jinf.2020.07.036","article-title":"Early identification of patients with severe influenza-associated aspergillosis (IAA) in the intensive care unit\u2013an IAA prediction score system (Asper-PreSS).","volume":"81","author":"Huang","year":"2020","journal-title":"J. Infect."},{"key":"B57","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/myc.13472","article-title":"Cytomegalovirus viral interleukin-10 in patients with Aspergillus infection and effects on clinical outcome.","volume":"65","author":"Huang","year":"2022","journal-title":"Mycoses"},{"key":"B58","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1038\/s41586-022-04479-6","article-title":"SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo.","volume":"603","author":"Hui","year":"2022","journal-title":"Nature"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1093\/infdis\/jit099","article-title":"The Phenotype of the cryptococcus-specific CD4+ Memory T-cell response is associated with disease severity and outcome in HIV-associated cryptococcal meningitis.","volume":"207","author":"Jarvis","year":"2013","journal-title":"J. Infect. Dis."},{"key":"B60","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1097\/QAD.0b013e3283536a93","article-title":"Adjunctive interferon-\u03b3 immunotherapy for the treatment of HIV-associated cryptococcal meningitis: a randomized controlled trial.","volume":"26","author":"Jarvis","year":"2012","journal-title":"AIDS"},{"key":"B61","doi-asserted-by":"publisher","first-page":"9404","DOI":"10.1073\/pnas.152147499","article-title":"Crystal structure of human cytomegalovirus IL-10 bound to soluble human IL-10R1.","volume":"99","author":"Jones","year":"2002","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"key":"B62","doi-asserted-by":"publisher","first-page":"2575","DOI":"10.3390\/v14112575","article-title":"Immune-mediated pathogenesis in dengue virus infection.","volume":"14","author":"Khanam","year":"2022","journal-title":"Viruses"},{"key":"B63","doi-asserted-by":"publisher","first-page":"692","DOI":"10.3201\/eid2604.191011","article-title":"Severe fever with thrombocytopenia syndrome, Japan, 2013-2017.","volume":"26","author":"Kobayashi","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"B64","doi-asserted-by":"publisher","first-page":"105264","DOI":"10.1016\/j.micinf.2023.105264","article-title":"The influenza A virus promotes fungal growth of Aspergillus fumigatus via direct interaction in vitro.","volume":"26","author":"K\u00f6nig","year":"2024","journal-title":"Microbes Infect."},{"key":"B65","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1146\/annurev.immunol.021908.132710","article-title":"IL-17 and Th17 Cells.","volume":"27","author":"Korn","year":"2009","journal-title":"Annu. Rev. Immunol."},{"key":"B66","doi-asserted-by":"publisher","first-page":"971","DOI":"10.3201\/eid1606.100165","article-title":"Invasive aspergillosis after pandemic (H1N1) 2009.","volume":"16","author":"Lat","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"B67","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.mucimm.2024.01.003","article-title":"Immunity to pathogenic mucosal C. albicans infections mediated by oral megakaryocytes activated by IL-17 and candidalysin.","volume":"17","author":"Launder","year":"2024","journal-title":"Mucosal Immunol."},{"key":"B68","doi-asserted-by":"publisher","first-page":"839","DOI":"10.3109\/08820139.2011.581732","article-title":"Immunotherapy against invasive fungal diseases in stem cell transplant recipients.","volume":"40","author":"Lehrnbecher","year":"2011","journal-title":"Immunol. Invest."},{"key":"B69","doi-asserted-by":"publisher","first-page":"e02347","DOI":"10.1016\/j.idcr.2025.e02347","article-title":"A patient with severe fever with thrombocytopenia syndrome complicated with intracranial and pulmonary aspergillosis.","volume":"41","author":"Li","year":"2025","journal-title":"IDCases"},{"key":"B70","doi-asserted-by":"publisher","first-page":"657","DOI":"10.4049\/jimmunol.169.2.657","article-title":"Endothelial cell apoptosis induced by antibodies against dengue virus nonstructural protein 1 via production of nitric oxide.","volume":"169","author":"Lin","year":"2002","journal-title":"J. Immunol."},{"key":"B71","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1016\/j.jiph.2023.09.008","article-title":"Aspergillus coinfection in critically Ill patients with severe dengue.","volume":"16","author":"Lin","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"B72","doi-asserted-by":"publisher","first-page":"e0285422","DOI":"10.1128\/mbio.02854-22","article-title":"Postinfluenza environment reduces Aspergillus fumigatus conidium clearance and facilitates invasive Aspergillosis in vivo.","volume":"13","author":"Liu","year":"2022","journal-title":"mBio"},{"key":"B73","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.chest.2023.09.019","article-title":"Prevalence, risk factors, clinical features, and outcome of influenza-associated pulmonary Aspergillosis in critically ill patients: a systematic review and meta-analysis.","volume":"165","author":"Lu","year":"2024","journal-title":"Chest"},{"key":"B74","doi-asserted-by":"publisher","first-page":"2587374","DOI":"10.1080\/21505594.2025.2587374","article-title":"Severe fever with thrombocytopenia syndrome virus infection induces thymic atrophy in IFNAR-\/- mice.","volume":"16","author":"Ma","year":"2025","journal-title":"Virulence"},{"key":"B75","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1186\/s12879-018-3548-0","article-title":"The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09.","volume":"18","author":"MacIntyre","year":"2018","journal-title":"BMC Infect. Dis."},{"key":"B76","doi-asserted-by":"publisher","first-page":"e85084","DOI":"10.7759\/cureus.85084","article-title":"Unmasking the hidden threat: invasive pulmonary aspergillosis following dengue hemorrhagic fever in an immunocompetent patient.","volume":"17","author":"Masud","year":"2025","journal-title":"Cureus"},{"key":"B77","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1111\/myc.13292","article-title":"Incidence and mortality of COVID-19-associated pulmonary aspergillosis: a systematic review and meta-analysis.","volume":"64","author":"Mitaka","year":"2021","journal-title":"Mycoses"},{"key":"B78","doi-asserted-by":"publisher","first-page":"e2119680119","DOI":"10.1073\/pnas.2119680119","article-title":"SARS-CoV-2 infection of airway cells causes intense viral and cell shedding, two spreading mechanisms affected by IL-13.","volume":"119","author":"Morrison","year":"2022","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"key":"B79","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1111\/myc.13135","article-title":"COVID-19-associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID-19 pneumonia: an observational study from Pakistan.","volume":"63","author":"Nasir","year":"2020","journal-title":"Mycoses"},{"key":"B80","doi-asserted-by":"publisher","first-page":"5921","DOI":"10.1128\/JVI.73.13.5921-5929.2001","article-title":"Human lymphocyte apoptosis after exposure to influenza A virus.","volume":"75","author":"Nichols","year":"2001","journal-title":"J. Virol."},{"key":"B81","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/j.immuni.2024.04.008","article-title":"Platelets: orchestrators of immunity in host defense and beyond.","volume":"57","author":"Nicolai","year":"2024","journal-title":"Immunity"},{"key":"B82","doi-asserted-by":"publisher","first-page":"419","DOI":"10.3389\/fcimb.2017.00419","article-title":"Influenza A virus as a predisposing factor for cryptococcosis.","volume":"7","author":"Oliveira","year":"2017","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B83","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1099\/vir.0.058966-0","article-title":"IL-10 encoded by viruses: a remarkable example of independent acquisition of a cellular gene by viruses and its subsequent evolution in the viral genome.","volume":"95","author":"Ouyang","year":"2014","journal-title":"J. Gen. Virol."},{"key":"B84","doi-asserted-by":"publisher","first-page":"1452","DOI":"10.1111\/myc.13338","article-title":"COVID-19-associated mucormycosis: an updated systematic review of literature.","volume":"64","author":"Pal","year":"2021","journal-title":"Mycoses"},{"key":"B85","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1097\/QAD.0b013e328322ffac","article-title":"Estimation of the current global burden of cryptococcal meningitis among persons living with HIV\/AIDS.","volume":"23","author":"Park","year":"2009","journal-title":"AIDS"},{"key":"B86","doi-asserted-by":"publisher","first-page":"2414","DOI":"10.1007\/s42399-020-00574-9","article-title":"Detected SARS-CoV-2 in ascitic fluid followed by cryptococcemia: a case report.","volume":"2","author":"Passarelli","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"B87","doi-asserted-by":"publisher","first-page":"262471","DOI":"10.1155\/2012\/262471","article-title":"The changing epidemiology of oropharyngeal candidiasis in patients with HIV\/AIDS in the era of antiretroviral therapy.","volume":"2012","author":"Patel","year":"2012","journal-title":"AIDS Res. Treat."},{"key":"B88","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1177\/00494755241269196","article-title":"Post-dengue mucormycosis- a novel entity or COVID-19 associated in disguise?","volume":"54","author":"Popli","year":"2024","journal-title":"Trop. Doct."},{"key":"B89","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.cmi.2021.08.014","article-title":"Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology.","volume":"28","author":"Prattes","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"B90","doi-asserted-by":"publisher","first-page":"10","DOI":"10.4038\/cmj.v60i1.7165","article-title":"Secondary bacteraemia in adult patients with prolonged dengue fever.","volume":"60","author":"Premaratna","year":"2015","journal-title":"Ceylon Med. J."},{"key":"B91","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1186\/s12879-020-05637-9","article-title":"Specific dynamic variations in the peripheral blood lymphocyte subsets in COVID-19 and severe influenza A patients: a retrospective observational study.","volume":"20","author":"Qian","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B92","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1093\/qjmed\/hcab190","article-title":"COVID-19-associated mucormycosis presenting to the Emergency Department-an observational study of 70 patients.","volume":"114","author":"Ramaswami","year":"2021","journal-title":"QJM"},{"key":"B93","doi-asserted-by":"publisher","first-page":"6104054","DOI":"10.1155\/2017\/6104054","article-title":"IL-10: a multifunctional cytokine in viral infections.","volume":"2017","author":"Rojas","year":"2017","journal-title":"J. Immunol. Res."},{"key":"B94","doi-asserted-by":"publisher","first-page":"e249814","DOI":"10.1136\/bcr-2022-249814","article-title":"Postoperative dengue haemorrhagic shock and Trichosporon fungal sepsis: a multidisciplinary rescue.","volume":"15","author":"Sachan","year":"2022","journal-title":"BMJ Case Rep."},{"key":"B95","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1111\/myc.13137","article-title":"Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: species identification and antifungal susceptibility pattern.","volume":"63","author":"Salehi","year":"2020","journal-title":"Mycoses"},{"key":"B96","doi-asserted-by":"publisher","first-page":"eabq6682","DOI":"10.1126\/scitranslmed.abq6682","article-title":"A B1a-natural IgG-neutrophil axis is impaired in viral- and steroid-associated aspergillosis.","volume":"14","author":"Sarden","year":"2022","journal-title":"Sci. Transl. Med."},{"key":"B97","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/S2213-2600(18)30274-1","article-title":"Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study.","volume":"6","author":"Schauwvlieghe","year":"2018","journal-title":"Lancet Respir. Med."},{"key":"B98","doi-asserted-by":"publisher","first-page":"e00784-19","DOI":"10.1128\/IAI.00784-19","article-title":"Stepping up to the plate(let) against Candida albicans.","volume":"88","author":"Schultz","year":"2020","journal-title":"Infect. Immun."},{"key":"B99","doi-asserted-by":"publisher","first-page":"105347","DOI":"10.1016\/j.ebiom.2024.105347","article-title":"Damping excessive viral-induced IFN-\u03b3 rescues the impaired anti-Aspergillus host immune response in influenza-associated pulmonary aspergillosis.","volume":"108","author":"Seldeslachts","year":"2024","journal-title":"eBioMedicine"},{"key":"B100","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.4103\/ijo.IJO_1565_21","article-title":"Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India - Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1.","volume":"69","author":"Sen","year":"2021","journal-title":"Indian J. Ophthalmol."},{"key":"B101","doi-asserted-by":"publisher","first-page":"e0251955","DOI":"10.1371\/journal.pone.0251955","article-title":"SARS-CoV-2 Envelope (E) protein interacts with PDZ-domain-2 of host tight junction protein ZO1.","volume":"16","author":"Shepley-McTaggart","year":"2021","journal-title":"PLoS One"},{"key":"B102","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1111\/myc.13410","article-title":"Incidence, risk factors and mortality of invasive pulmonary aspergillosis in patients with influenza: a systematic review and meta-analysis.","volume":"65","author":"Shi","year":"2022","journal-title":"Mycoses"},{"key":"B103","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1186\/s12964-024-01718-3","article-title":"SARS-CoV-2-associated lymphopenia: possible mechanisms and the role of CD147.","volume":"22","author":"Shouman","year":"2024","journal-title":"Cell Commun. Signal"},{"key":"B104","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.jhin.2021.04.001","article-title":"Fungal and bacterial coinfections increase mortality of severely ill COVID-19 patients.","volume":"113","author":"Silva","year":"2021","journal-title":"J. Hosp. Infect."},{"key":"B105","doi-asserted-by":"publisher","first-page":"3321","DOI":"10.1007\/s12070-022-03152-8","article-title":"Invasive fungal infections in dengue recovered patients: a new phenomenon in the Covid-19 Era.","volume":"74","author":"Singhal","year":"2022","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"B106","doi-asserted-by":"publisher","first-page":"e0004497","DOI":"10.1371\/journal.pntd.0004497","article-title":"Immune response to dengue virus infection in pediatric patients in New Delhi, India\u2014association of viremia, inflammatory mediators and monocytes with disease severity.","volume":"10","author":"Singla","year":"2016","journal-title":"PLoS Neglect. Trop. Dis."},{"key":"B107","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1093\/cid\/ciz864","article-title":"Cytomegalovirus viremia associated with increased mortality in cryptococcal meningitis in Sub-Saharan Africa.","volume":"71","author":"Skipper","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"B108","doi-asserted-by":"publisher","first-page":"1298050","DOI":"10.3389\/fcimb.2023.1298050","article-title":"The pathogenic and clinical characteristics of severe fever with thrombocytopenia syndrome patients with co-infections.","volume":"13","author":"Song","year":"2023","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B109","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1038\/s41598-023-28851-2","article-title":"Investigation of predictors for invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome.","volume":"13","author":"Song","year":"2023","journal-title":"Sci. Rep."},{"key":"B110","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s12985-024-02403-0","article-title":"Cytokines and lymphocyte subsets are associated with disease severity of severe fever with thrombocytopenia syndrome.","volume":"21","author":"Song","year":"2024","journal-title":"Virol. J."},{"key":"B111","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1128\/jvi.76.3.1285-1292.2002","article-title":"Potent immunosuppressive activities of cytomegalovirus-encoded interleukin-10.","volume":"76","author":"Spencer","year":"2002","journal-title":"J. Virol."},{"key":"B112","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1093\/infdis\/jis743","article-title":"Aspergillus fumigatus activates thrombocytes by secretion of soluble compounds.","volume":"207","author":"Speth","year":"2013","journal-title":"J. Infect. Dis."},{"key":"B113","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1093\/infdis\/157.5.1032","article-title":"Comparison of translocation rates of various indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node.","volume":"157","author":"Steffen","year":"1988","journal-title":"J. Infect. Dis."},{"key":"B114","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1038\/nm.1929","article-title":"Effector T cells control lung inflammation during acute influenza virus infection by producing IL-10.","volume":"15","author":"Sun","year":"2009","journal-title":"Nat. Med."},{"key":"B115","doi-asserted-by":"publisher","first-page":"5007","DOI":"10.1128\/JVI.02408-09","article-title":"A detrimental effect of interleukin-10 on protective pulmonary humoral immunity during primary influenza A virus infection.","volume":"84","author":"Sun","year":"2010","journal-title":"J. Virol."},{"key":"B116","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.2169\/internalmedicine.46.6354","article-title":"Dengue hemorrhagic shock and disseminated candidiasis.","volume":"46","author":"Suzuki","year":"2007","journal-title":"Intern. Med."},{"key":"B117","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s11046-022-00670-5","article-title":"Risk Factors of COVID-19 Associated Mucormycosis (CAM) in Iranian patients: a single-center retrospective study.","volume":"187","author":"Tavakolpour","year":"2022","journal-title":"Mycopathologia"},{"key":"B118","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1038\/s41577-020-0311-8","article-title":"The trinity of COVID-19: immunity, inflammation and intervention.","volume":"20","author":"Tay","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"B119","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.mib.2020.09.011","article-title":"Eradicating, retaining, balancing, swarming, shuttling and dumping: a myriad of tasks for neutrophils during fungal infection.","volume":"58","author":"Urban","year":"2020","journal-title":"Curr. Opin. Microbiol."},{"key":"B120","doi-asserted-by":"publisher","first-page":"464","DOI":"10.4103\/JLP.JLP_71_18","article-title":"Catheter associated urinary tract infections due to Trichosporon asahii.","volume":"10","author":"Urs","year":"2018","journal-title":"J. Lab. Phys."},{"key":"B121","first-page":"79","article-title":"An evidence of intestinal mucosal injury in dengue infection.","volume":"37","author":"Vejchapipat","year":"2006","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"B122","doi-asserted-by":"publisher","first-page":"e13059","DOI":"10.1111\/irv.13059","article-title":"Higher risk for Influenza-Associated Pulmonary Aspergillosis (IAPA) in asthmatic patients: a Swiss multicenter cohort study on IAPA in critically ill influenza patients.","volume":"17","author":"Waldeck","year":"2023","journal-title":"Influenza Other Respir. Viruses"},{"key":"B123","doi-asserted-by":"publisher","first-page":"1448710","DOI":"10.3389\/fmicb.2024.1448710","article-title":"Clinical factors associated with invasive pulmonary Aspergillosis in patients with severe fever with thrombocytopenia syndrome: analysis of a 6-year clinical experience.","volume":"15","author":"Wang","year":"2024","journal-title":"Front. Microbiol."},{"key":"B124","doi-asserted-by":"publisher","first-page":"4496","DOI":"10.3390\/ijms22094496","article-title":"Hypoalbuminemia as surrogate and culprit of infections.","volume":"22","author":"Wiedermann","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B125","unstructured":"WHO Fungal Priority Pathogens List to Guide Research, Development and Public Health Action.\n          \n          2025"},{"key":"B126","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1186\/s12890-025-03671-4","article-title":"Impact of physician awareness and microbiological examination on incidence of COVID-19-associated pulmonary aspergillosis: a retrospective study.","volume":"25","author":"Xia","year":"2025","journal-title":"BMC Pulm. Med."},{"key":"B127","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1038\/s41392-024-01753-z","article-title":"SARS-CoV-2 envelope protein impairs airway epithelial barrier function and exacerbates airway inflammation via increased intracellular Cl- concentration.","volume":"9","author":"Xu","year":"2024","journal-title":"Signal Transduct. Target Ther."},{"key":"B128","doi-asserted-by":"publisher","first-page":"3000605251344140","DOI":"10.1177\/03000605251344140","article-title":"Post-COVID-19 severe Pneumocystis jirovecii pneumonia in a non-HIV and immunocompetent patient: a case report and literature review.","volume":"53","author":"Xu","year":"2025","journal-title":"J. Int. Med. Res."},{"key":"B129","doi-asserted-by":"publisher","first-page":"e29647","DOI":"10.1002\/jmv.29647","article-title":"Risk factors for invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome: a multicenter retrospective study.","volume":"96","author":"Yao","year":"2024","journal-title":"J. Med. Virol."},{"key":"B130","doi-asserted-by":"publisher","first-page":"26586","DOI":"10.1074\/jbc.M112.376707","article-title":"Epstein-Barr virus IL-10 engages IL-10R1 by a two-step mechanism leading to altered signaling properties.","volume":"287","author":"Yoon","year":"2012","journal-title":"J. Biol. Chem."},{"key":"B131","doi-asserted-by":"publisher","first-page":"1948","DOI":"10.3201\/eid3009.240615","article-title":"Non-HIV immunocompetent patient with COVID-19 and severe Pneumocystis jirovecii pneumonia co-infection.","volume":"30","author":"Yu","year":"2024","journal-title":"Emerg. Infect. Dis."},{"key":"B132","doi-asserted-by":"publisher","first-page":"104364","DOI":"10.1016\/j.jcv.2020.104364","article-title":"Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China.","volume":"127","author":"Zhang","year":"2020","journal-title":"J. Clin. Virol."},{"key":"B133","doi-asserted-by":"publisher","first-page":"5916","DOI":"10.1002\/jmv.28059","article-title":"Associated microbiota and treatment of severe fever with thrombocytopenia syndrome complicated with infections.","volume":"94","author":"Zhang","year":"2022","journal-title":"J. Med. Virol."},{"key":"B134","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s43556-025-00301-7","article-title":"Mucosal immunity and vaccination strategies: current insights and future perspectives.","volume":"6","author":"Zhang","year":"2025","journal-title":"Mol. Biomed."},{"key":"B135","doi-asserted-by":"publisher","first-page":"ofae108","DOI":"10.1093\/ofid\/ofae108","article-title":"Incidence and Mortality of COVID-19-associated invasive fungal infections among critically ill intubated patients: a multicenter retrospective cohort analysis.","volume":"11","author":"Zuniga-Moya","year":"2024","journal-title":"Open Forum Infect. Dis."},{"key":"B136","doi-asserted-by":"publisher","first-page":"e28712","DOI":"10.1002\/jmv.28712","article-title":"Pulmonary infection in patients with severe fever with thrombocytopenia syndrome: a multicentre observational study.","volume":"95","author":"Zuo","year":"2023","journal-title":"J. Med. Virol."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1780547\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:42:39Z","timestamp":1772779359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1780547\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":136,"alternative-id":["10.3389\/fmicb.2026.1780547"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1780547","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"article-number":"1780547"}}