RESUMEN
Severe acute respiratory syndrome coronavirus 2 can lead to life-threatening coronavirus disease 2019 (COVID-19) infections in patients with hematologic malignancies, particularly among hematopoietic cell transplant (HCT) recipients. We describe two patients with COVID-19 during the pre-engraftment period after HCT and review previous reports of COVID-19 in HCT recipients. Because of significant mortality from COVID-19, primarily after allogeneic HCT, early, preemptive, and optimal directed therapy may improve outcomes and reduce the mortality rate but still needs to be established in clinical trials.
Asunto(s)
COVID-19 , Trasplante de Células Madre Hematopoyéticas , Reconstitución Inmune , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , SARS-CoV-2 , Receptores de TrasplantesAsunto(s)
Huésped Inmunocomprometido , Nocardiosis/diagnóstico por imagen , Anciano , Antibacterianos/uso terapéutico , Encéfalo/diagnóstico por imagen , Encéfalo/microbiología , Líquido del Lavado Bronquioalveolar/microbiología , Resultado Fatal , Femenino , Humanos , Nocardia/genética , Nocardiosis/tratamiento farmacológico , ARN Ribosómico 16S/genética , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE OF REVIEW: This review summarizes the investigational antifungals in clinical development with the potential to address rising drug resistance patterns. The relevant pharmacodynamics, spectrum of activity, preclinical studies, and latest clinical trial data are described. RECENT FINDINGS: Agricultural and medicinal antifungal use has been selected for inherently drug-resistant fungi and acquired resistance mechanisms. The rates of fungal infections and immunocompromised populations continue to grow as few new antifungals have hit the market. Several agents with the potential to address the emergence of multidrug-resistant (MDR) molds and yeasts are in clinical development. SUMMARY: Evolved formulations of echinocandins, polyenes, and triazoles offer less toxicity, convenient dosing, and greater potency, potentially expanding these classes' indications. Ibrexafungerp, olorofim, oteseconazole, and fosmanogepix possess novel mechanisms of actions with potent activity against MDR fungi. Successful clinical development is neither easy nor guaranteed; thus, perpetual efforts to discover new antifungals are needed.