{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:25:06Z","timestamp":1783700706031,"version":"3.55.0"},"reference-count":83,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Coronavirus disease 2019 (COVID-19) may occur with concurrent infections caused by bacterial and fungal microorganisms. This systematic review evaluated studies reporting concomitant COVID-19 and Pneumocystis jirovecii pneumonia (PJP). We found 39 patients (74% male, median age: 56.8 (range: 11\u201383) years), including 66% immunosuppressed individuals (23% HIV-infected and 41% on long-term corticosteroid therapy). Patients were characteristically severely ill (mechanical ventilation: 70%), associated with 41% mortality. The median lymphocyte count was 527 cells\/mm3 (range: 110\u20132200), and the median CD4+ T cell count was 206 cells\/mm3 (range: 8\u20131021). We identified three patterns of concurrent COVID-19 and P. jirovecii infection. The first pattern (airway colonization with a low burden of P. jirovecii) does not seem to modify the COVID-19 course of illness. However, P. jirovecii superinfection, typically occurring weeks after COVID-19 diagnosis as a biphasic illness, and P. jirovecii coinfection characteristically results in progressive multilobar pneumonia, which is associated with poor outcomes. To support this categorization, we reported three patients with concurrent PJP and COVID-19 identified in our institution, presenting these clinical scenarios. The diagnosis of PJP requires a high index of suspicion, since clinical and radiological characteristics overlap with COVID-19. Observational studies are necessary to determine the PJP burden in patients with COVID-19 requiring hospitalization.<\/jats:p>","DOI":"10.3390\/jof8060585","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T10:05:14Z","timestamp":1653905114000},"page":"585","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Concurrent Infection with SARS-CoV-2 and Pneumocystis jirovecii in Immunocompromised and Immunocompetent Individuals"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7988-6945","authenticated-orcid":false,"given":"Francesca","family":"Gioia","sequence":"first","affiliation":[{"name":"Transplant Infectious Diseases Program, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2N2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6513-7206","authenticated-orcid":false,"given":"Hanan","family":"Albasata","sequence":"additional","affiliation":[{"name":"Transplant Infectious Diseases Program, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2N2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-2458","authenticated-orcid":false,"given":"Seyed M.","family":"Hosseini-Moghaddam","sequence":"additional","affiliation":[{"name":"Transplant Infectious Diseases Program, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2N2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"739","DOI":"10.12688\/f1000research.10619.1","article-title":"Pneumocystis Jirovecii Detection in Asymptomatic Patients: What Does Its Natural History Tell Us?","volume":"6","author":"Alanio","year":"2017","journal-title":"F1000Research"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Vera, C., and Rueda, Z.V. (2021). Transmission and Colonization of Pneumocystis Jirovecii. J. Fungi, 7.","DOI":"10.3390\/jof7110979"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1007\/s10096-017-3006-8","article-title":"Importance of Tissue Sampling, Laboratory Methods, and Patient Characteristics for Detection of Pneumocystis in Autopsied Lungs of Non-Immunosuppressed Individuals","volume":"36","author":"Vargas","year":"2017","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3201\/eid1102.040487","article-title":"Pneumocystis Jirovecii in General Population","volume":"11","author":"Medrano","year":"2005","journal-title":"Emerg. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"605","DOI":"10.3201\/eid0905.020660","article-title":"Pregnancy and Asymptomatic Carriage of Pneumocystis Jiroveci","volume":"9","author":"Vargas","year":"2003","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1086\/649868","article-title":"Pneumocystis Colonization Is Highly Prevalent in the Autopsied Lungs of the General Population","volume":"50","author":"Ponce","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e1060","DOI":"10.1016\/j.ijid.2010.07.003","article-title":"Seroepidemiological Study of Pneumocystis Jirovecii Infection in Healthy Infants in Chile Using Recombinant Fragments of the P. Jirovecii Major Surface Glycoprotein","volume":"14","author":"Djawe","year":"2010","journal-title":"Int. J. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1128\/JCM.02381-13","article-title":"Prevalence and Genotype Distribution of Pneumocystis Jirovecii in Cuban Infants and Toddlers with Whooping Cough","volume":"52","author":"Diaz","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1086\/319340","article-title":"Search for Primary Infection by Pneumocystis Carinii in a Cohort of Normal, Healthy Infants","volume":"32","author":"Vargas","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1111\/j.1469-0691.2004.00974.x","article-title":"High Seroprevalence of Pneumocystis Infection in Spanish Children","volume":"10","author":"Respaldiza","year":"2004","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1177\/1060028016650107","article-title":"Pneumocystis Jirovecii Pneumonia in the Non\u2013HIV-Infected Population","volume":"50","author":"Avino","year":"2016","journal-title":"Ann. Pharmacother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and Update of the Consensus Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium","volume":"71","author":"Chen","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1093\/cid\/ciaa904","article-title":"Immune Immunomodulation in Coronavirus Disease 2019 (COVID-19): Strategic Considerations for Personalized Therapeutic Intervention","volume":"74","author":"Hall","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.chom.2020.04.009","article-title":"Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure","volume":"27","author":"Netea","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_15","first-page":"2459","article-title":"Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing","volume":"71","author":"Rawson","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.cmi.2020.10.021","article-title":"Secondary Infections in Patients Hospitalized with COVID-19: Incidence and Predictive Factors","volume":"27","author":"Ripa","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group, Horby, P., Lim, W.S., Emberson, J.R., Mafham, M., Bell, J.L., Linsell, L., Staplin, N., Brightling, C., and Ustianowski, A. (2021). Dexamethasone in Hospitalized Patients with COVID-19. N. Engl. J. Med., 384, 693\u2013704.","DOI":"10.1056\/NEJMoa2021436"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1001\/jama.2020.17023","article-title":"Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19","volume":"324","author":"Sterne","year":"2020","journal-title":"JAMA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1016\/j.cmi.2020.06.025","article-title":"Bacterial and Fungal Coinfection among Hospitalized Patients with COVID-19: A Retrospective Cohort Study in a UK Secondary-Care Setting","volume":"26","author":"Hughes","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Baddley, J.W., Thompson, G.R., Chen, S.C.-A., White, P.L., Johnson, M.D., Nguyen, M.H., Schwartz, I.S., Spec, A., Ostrosky-Zeichner, L., and Jackson, B.R. (2021). Coronavirus Disease 2019\u2013Associated Invasive Fungal Infection. Open Forum Infect. Dis., 8.","DOI":"10.1093\/ofid\/ofab510"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Feys, S., Almyroudi, M.P., Braspenning, R., Lagrou, K., Spriet, I., Dimopoulos, G., and Wauters, J. (2021). A Visual and Comprehensive Review on COVID-19-Associated Pulmonary Aspergillosis (CAPA). J. Fungi, 7.","DOI":"10.3390\/jof7121067"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/S2213-2600(21)00442-2","article-title":"Fungal Infections in Mechanically Ventilated Patients with COVID-19 during the First Wave: The French Multicentre MYCOVID Study","volume":"10","author":"Gangneux","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: Consider Cytokine Storm Syndromes and Immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cmi.2020.07.041","article-title":"Incidence of Co-Infections and Superinfections in Hospitalized Patients with COVID-19: A Retrospective Cohort Study","volume":"27","author":"Sanjuan","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e1645","DOI":"10.1093\/cid\/ciaa1342","article-title":"Invasive Fungal Disease Complicating Coronavirus Disease 2019: When It Rains, It Spores","volume":"73","author":"Hoenigl","year":"2021","journal-title":"Clin. Infect. Dis. An Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100971","DOI":"10.1016\/j.mycmed.2020.100971","article-title":"Invasive Fungal Diseases during COVID-19: We Should Be Prepared","volume":"30","author":"Gangneux","year":"2020","journal-title":"J. Mycol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s11046-020-00462-9","article-title":"Fungal Co-Infections Associated with Global COVID-19 Pandemic: A Clinical and Diagnostic Perspective from China","volume":"185","author":"Song","year":"2020","journal-title":"Mycopathologia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1111\/myc.13096","article-title":"COVID-19 Associated Pulmonary Aspergillosis","volume":"63","author":"Koehler","year":"2020","journal-title":"Mycoses"},{"key":"ref_29","doi-asserted-by":"crossref","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":"ref_30","doi-asserted-by":"crossref","unstructured":"Jeican, I.I., Ini\u0219ca, P., Gheban, D., T\u0103b\u0103ran, F., Alua\u0219, M., Trombitas, V., Cristea, V., Crivii, C., Junie, L.M., and Albu, S. (2021). COVID-19 and Pneumocystis Jirovecii Pulmonary Coinfection\u2014The First Case Confirmed through Autopsy. Medicina, 57.","DOI":"10.3390\/medicina57040302"},{"key":"ref_31","first-page":"590","article-title":"Pneumocystis Pneumonia, a COVID-19 Mimic, Reminds Us of the Importance of HIV Testing in COVID-19","volume":"20","author":"Kelly","year":"2020","journal-title":"Clin. Med. J. R. Coll. Physicians"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1128\/JCM.02876-15","article-title":"Performances of Four Real-Time PCR Assays for Diagnosis of Pneumocystis Jirovecii Pneumonia","volume":"54","author":"Sasso","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1183\/09031936.02.01372002","article-title":"Meta-Analysis of Diagnostic Procedures for Pneumocystis Carinii Pneumonia in HIV-1-Infected Patients","volume":"20","author":"Cruciani","year":"2002","journal-title":"Eur. Respir. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jinf.2020.10.034","article-title":"The Presence of Pneumocystis Jirovecii in Critically Ill Patients with COVID-19","volume":"82","author":"Alanio","year":"2021","journal-title":"J. Infect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1164\/rccm.202003-0766LE","article-title":"A Case of COVID-19 and Pneumocystis Jirovecii Coinfection","volume":"202","author":"Menon","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1093\/cid\/ciaa906","article-title":"Pneumocystis Jirovecii Pneumonia and Severe Acute Respiratory Syndrome Coronavirus 2 Coinfection in a Patient With Newly Diagnosed HIV-1 Infection","volume":"72","author":"Mang","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1097\/QAD.0000000000002571","article-title":"Coronavirus Disease 2019 and Pneumocystis Jirovecii Pneumonia: A Diagnostic Dilemma in HIV","volume":"34","author":"Coleman","year":"2020","journal-title":"AIDS"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ijid.2020.07.061","article-title":"Concurrent COVID-19 and Pneumocystis Jirovecii Pneumonia in a Severely Immunocompromised 25-Year-Old Patient","volume":"99","author":"Bhat","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"De Francesco, M.A., Alberici, F., Bossini, N., Scolari, F., Pascucci, F., Tomasoni, G., and Caruso, A. (2020). Pneumocystis Jirevocii and SARS-CoV-2 Co-Infection: A Common Feature in Transplant Recipients?. Vaccines, 8.","DOI":"10.3390\/vaccines8030544"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Gerber, V., Ruch, Y., Chamaraux-Tran, T.-N.N., Oulehri, W., Schneider, F., Lindner, V., Greigert, V., Denis, J., Brunet, J., and Danion, F. (2021). Detection of Pneumocystis Jirovecii in Patients with Severe COVID-19: Diagnostic and Therapeutic Challenges. J. Fungi, 7.","DOI":"10.3390\/jof7080585"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100047","DOI":"10.1016\/j.liver.2021.100047","article-title":"Co-Infection with SARS-CoV-2 and Pneumocystis Jirovecii in Liver Transplant Recipients: A Double Whammy","volume":"4","author":"Kronsten","year":"2021","journal-title":"J. Liver Transplant."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Gentile, I., Viceconte, G., Lanzardo, A., Zotta, I., Zappulo, E., Pinchera, B., Scotto, R., Moriello, N.S., Foggia, M., and Giaccone, A. (2021). Pneumocystis Jirovecii Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111399"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2797","DOI":"10.1007\/s10067-020-05234-w","article-title":"A Complex COVID-19 Case with Rheumatoid Arthritis Treated with Tocilizumab","volume":"39","author":"Cai","year":"2020","journal-title":"Clin. Rheumatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e00725","DOI":"10.1002\/rcr2.725","article-title":"The Diagnostic Challenge of Pneumocystis Pneumonia and COVID-19 Co-Infection in HIV","volume":"9","author":"Broadhurst","year":"2021","journal-title":"Respirol. Case Rep."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Rubiano, C., Tompkins, K., Sellers, S.A., Bramson, B., Eron, J., Parr, J.B., and Schranz, A.J. (2021). Pneumocystis and Severe Acute Respiratory Syndrome Coronavirus 2 Coinfection: A Case Report and Review of an Emerging Diagnostic Dilemma. Open Forum Infect. Dis., 8.","DOI":"10.1093\/ofid\/ofaa633"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1080\/23744235.2021.1890331","article-title":"Pneumocystis Jirovecii Pneumonia in an Immunocompetent Patient Recovered from COVID-19","volume":"53","author":"Viceconte","year":"2021","journal-title":"Infect. Dis. (Auckl)."},{"key":"ref_47","first-page":"554","article-title":"[Simultaneous Diagnosis and Favorable Evolution of Infection with Pneumocystis Jirovecii, SARS-CoV-2 and Advanced HIV]","volume":"80","author":"Vilela","year":"2020","journal-title":"Medicina"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12941-021-00489-w","article-title":"Successful Treatment of a Kidney Transplant Patient with COVID-19 and Late-Onset Pneumocystis Jirovecii Pneumonia","volume":"20","author":"Peng","year":"2021","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_49","first-page":"100814","article-title":"COVID-19 and Pneumocystis Jirovecii Pneumonia: Back to the Basics","volume":"79","author":"Mouren","year":"2021","journal-title":"Respir. Med. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/24725625.2020.1832755","article-title":"Fatal Outcome of Anti-MDA5 Juvenile Dermatomyositis in a Paediatric COVID-19 Patient: A Case Report","volume":"5","author":"Remesal","year":"2021","journal-title":"Mod. Rheumatol. Case Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3685","DOI":"10.1016\/j.radcr.2021.09.002","article-title":"Concurrent COVID-19 and Pneumocystis Jirovecii Pneumonia: The Importance of Radiological Diagnostic and HIV Testing","volume":"16","author":"Anggraeni","year":"2021","journal-title":"Radiol. Case Rep."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Algar\u00edn-Lara, H., Osorio-Rodr\u00edguez, E., Pati\u00f1o-Pati\u00f1o, J., Mendoza-Morales, I., and Rodado-Villa, R. (2021). Neumon\u00eda Por SARS-CoV-2 Asociado a Coinfecci\u00f3n Por Pneumocystis Jirovecii En Paciente Inmunocomprometido: A Prop\u00f3sito de Un Caso y Revisi\u00f3n de La Literatura. Acta Colomb. Cuid. Intensivo.","DOI":"10.1016\/j.acci.2021.07.001"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e01153","DOI":"10.1016\/j.idcr.2021.e01153","article-title":"Co-Infection with Coronavirus Disease 2019, Previously Undiagnosed Human Immunodeficiency Virus, Pneumocystis Jirovecii Pneumonia and Cytomegalovirus Pneumonitis, with Possible Immune Reconstitution Inflammatory Syndrome","volume":"24","author":"Merchant","year":"2021","journal-title":"IDCases"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1164\/rccm.202007-2938LE","article-title":"COVID-19\u2013Related Respiratory Failure and Lymphopenia Do Not Seem Associated with Pneumocystosis","volume":"202","author":"Blaize","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"961","DOI":"10.3390\/curroncol28010094","article-title":"Not COVID-19, Don\u2019t Overlook Pneumocystis in Patients on Gefitinib!","volume":"28","author":"Barben","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_56","first-page":"1","article-title":"Diagnostic Challenges of Pneumocystis Pneumonia during the COVID-19 Pandemic: A Case of a Young Patient with Ground Glass Opacities and Pulmonary Embolism on Chest CT","volume":"2021","author":"Lim","year":"2021","journal-title":"Case Rep. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"473","DOI":"10.7196\/SAMJ.2020.v110i6.14825","article-title":"HIV and SARS-CoV-2 Co-Infection: The Diagnostic Challenges of Dual Pandemics","volume":"110","author":"Parker","year":"2020","journal-title":"S. Afr. Med. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1148\/radiol.2020200370","article-title":"Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19)","volume":"295","author":"Pan","year":"2020","journal-title":"Radiology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/s00330-002-1641-6","article-title":"Accuracy of High-Resolution CT in Distinguishing between Pneumocystis Carinii Pneumonia and Non-Pneumocystis Carinii Pneumonia in AIDS Patients","volume":"13","author":"Hidalgo","year":"2003","journal-title":"Eur. Radiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"E289","DOI":"10.1148\/radiol.2020202504","article-title":"Review of the Chest CT Differential Diagnosis of Ground-Glass Opacities in the COVID Era","volume":"297","author":"Parekh","year":"2020","journal-title":"Radiology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"200463","DOI":"10.1148\/radiol.2020200463","article-title":"Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection","volume":"295","author":"Bernheim","year":"2020","journal-title":"Radiology"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00408-009-9214-y","article-title":"Radiological Features of Pneumocystis Jirovecii Pneumonia in Immunocompromised Patients with and Without AIDS","volume":"188","author":"Hardak","year":"2010","journal-title":"Lung"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s41392-020-0148-4","article-title":"Lymphopenia Predicts Disease Severity of COVID-19: A Descriptive and Predictive Study","volume":"5","author":"Tan","year":"2020","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e12876","DOI":"10.1111\/tid.12876","article-title":"Lymphopenia Is Associated with Late Onset Pneumocystis Jirovecii Pneumonia in Solid Organ Transplantation","volume":"20","author":"Werbel","year":"2018","journal-title":"Transpl. Infect. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e12651","DOI":"10.1111\/tid.12651","article-title":"The Role of CD4 Cell Count as Discriminatory Measure to Guide Chemoprophylaxis against Pneumocystis Jirovecii Pneumonia in Human Immunodeficiency Virus-Negative Immunocompromised Patients: A Systematic Review","volume":"19","author":"Messiaen","year":"2017","journal-title":"Transpl. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1164\/rccm.201511-2205OC","article-title":"A Novel CD4 + T Cell\u2013Dependent Murine Model of Pneumocystis -Driven Asthma-like Pathology","volume":"194","author":"Eddens","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/cid\/ciaa248","article-title":"Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China","volume":"71","author":"Qin","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2487","DOI":"10.1056\/NEJMra032588","article-title":"Pneumocystis Pneumonia","volume":"350","author":"Thomas","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Bertuzzi, M., Hayes, G., Icheoku, U., van Rhijn, N., Denning, D., Osherov, N., and Bignell, E. (2018). Anti-Aspergillus Activities of the Respiratory Epithelium in Health and Disease. J. Fungi, 4.","DOI":"10.3390\/jof4010008"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1099\/jmm.0.000864","article-title":"Binding of Pneumocystis Carinii to the Lung Epithelial Cell Receptor HSPA5 (GRP78)","volume":"67","author":"Kottom","year":"2018","journal-title":"J. Med. Microbiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jcrc.2018.11.013","article-title":"Influenza Virus and Factors That Are Associated with ICU Admission, Pulmonary Co-Infections and ICU Mortality","volume":"50","author":"Beumer","year":"2019","journal-title":"J. Crit. Care"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Abdoli, A., Falahi, S., and Kenarkoohi, A. (2021). COVID-19-Associated Opportunistic Infections: A Snapshot on the Current Reports. Clin. Exp. Med.","DOI":"10.1007\/s10238-021-00751-7"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1093\/cid\/ciaa863","article-title":"COVID-19 in Immunocompromised Hosts: What We Know So Far","volume":"72","author":"Fung","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e002630","DOI":"10.1136\/jitc-2021-002630","article-title":"COVID-19 in Immunocompromised Populations: Implications for Prognosis and Repurposing of Immunotherapies","volume":"9","author":"Goldman","year":"2021","journal-title":"J. Immunother. Cancer"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jhep.2020.07.040","article-title":"Epidemiological Pattern, Incidence, and Outcomes of COVID-19 in Liver Transplant Patients","volume":"74","author":"Colmenero","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Casalini, G., Giacomelli, A., Ridolfo, A., Gervasoni, C., and Antinori, S. (2021). Invasive Fungal Infections Complicating COVID-19: A Narrative Review. J. Fungi, 7.","DOI":"10.3390\/jof7110921"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2892","DOI":"10.3201\/eid2711.211174","article-title":"Multinational Observational Cohort Study of COVID-19\u2013Associated Pulmonary Aspergillosis1","volume":"27","author":"Janssen","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e0122921","DOI":"10.1128\/JCM.01229-21","article-title":"Aspergillus Test Profiles and Mortality in Critically Ill COVID-19 Patients","volume":"59","author":"Alanio","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Prattes, J., Wauters, J., Giacobbe, D.R., Salmanton-Garc\u00eda, J., Maertens, J., Bourgeois, M., Reynders, M., Rutsaert, L., Van Regenmortel, N., and Lormans, P. (2021). Risk Factors and Outcome of Pulmonary Aspergillosis in Critically Ill Coronavirus Disease 2019 Patients\u2014a Multinational Observational Study by the European Confederation of Medical Mycology. Clin. Microbiol. Infect.","DOI":"10.2139\/ssrn.3868099"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.cmi.2020.10.036","article-title":"Efficacy and Safety of Tocilizumab in COVID-19 Patients: A Living Systematic Review and Meta-Analysis","volume":"27","author":"Tleyjeh","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Park, J.W., Curtis, J.R., Kim, M.J., Lee, H., Song, Y.W., and Lee, E.B. (2019). Pneumocystis Pneumonia in Patients with Rheumatic Diseases Receiving Prolonged, Non-High-Dose Steroids\u2014Clinical Implication of Primary Prophylaxis Using Trimethoprim\u2013Sulfamethoxazole. Arthritis Res. Ther., 21.","DOI":"10.1186\/s13075-019-1996-6"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4065\/71.1.5","article-title":"Pneumocystis Carinii Pneumonia in Patients Without Acquired Immunodeficiency Syndrome: Associated Illnesses and Prior Corticosteroid Therapy","volume":"71","author":"Yale","year":"1996","journal-title":"Mayo Clin. Proc."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/6\/585\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:21:55Z","timestamp":1760138515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/6\/585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":83,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["jof8060585"],"URL":"https:\/\/doi.org\/10.3390\/jof8060585","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,30]]}}}