TOPLINE:

During the COVID-19 pandemic, the incidence and severity of Aspergillus, Pneumocystis jirovecii, and Mucor infections rose in Spain despite the widespread use of face masks. SARS-CoV-2 coinfection most severely affected aspergillosis, resulting in increased ICU admissions, longer hospital stays, and increased mortality.

METHODOLOGY:

• Researchers in Spain conducted a retrospective longitudinal analysis of patients hospitalised with respiratory fungal infections to assess the impact of the COVID-19 pandemic and the use of face masks during this period on the incidence of these infections.
• They compared the incidence of primary and/or secondary diagnoses of aspergillosis, pneumocystosis, and mucormycosis between the pre-pandemic period (January 2017 to December 2019) and the pandemic period (January 2020 to December 2022).

TAKEAWAY:

• Overall, from 2017 to 2022, 17,374 patients were hospitalised with Aspergillus infection, 6598 with P jirovecii infection, and 474 with Mucor infection.
• The incidence of Aspergillus infection rose from 5.34 to 6.94 cases per 100,000 during the pandemic period — after an initial decline at the pandemic's onset, rates climbed sharply over the next 2 years — whereas P jirovecii and Mucor cases showed modest increases during the pandemic vs the pre-pandemic period.
• Case fatality rates increased significantly for all three fungal infections during the pandemic vs the pre-pandemic period; aspergillosis showed the largest rise, from 21.0% to 29.9% (P < .001).
• SARS-CoV-2 coinfection was most common in aspergillosis and was associated with significantly longer hospital and ICU stays for all three fungal infections, with the greatest impact seen on patients with aspergillosis.

IN PRACTICE:

"During the COVID-19 pandemic, the incidence of Aspergillus, Pneumocystis, and Mucor infections continued to increase in Spain despite the widespread use of face masks," the authors of the study wrote.

SOURCE:

This study was led by Raúl Parra Fariñas, MD, Servicio de Enfermedades Infecciosas, Hospital Marqués de Valdecilla, Universidad de Cantabria, IDIVAL (Instituto de Investigación Valdecilla), Santander, Spain, and Montserrat Alonso-Sardón, MD, PhD, Área de Medicina Preventiva y Salud Pública, Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain. It was published online on October 07, 2025, in the International Journal of Infectious Diseases.

LIMITATIONS:

This study relied on administrative data primarily collected for administrative rather than research purposes, which may have introduced classification bias. Limited access to comprehensive patient medical histories prevented independent verification of diagnoses. Additionally, the database lacked information on specific diagnostic tools used to confirm fungal infections, potentially leading to misclassification or underestimation.

DISCLOSURES:

This study did not report any funding information. The authors declared having no conflicts of interest relevant to this research.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.