The First Fungal Identification from Mini-BAL of Critical COVID-19 Patients

Background: coronavirus disease 2019 (covid-19) hasbecomea worldwide issue due to its high prevalence and rapid transmission. fungal infections have been detected in covid-19 patients, leading to increased morbidity and mortality. objectives: this study aimed to isolate aspergillus fumigatus and mucor spp. on mini-bronchoalveolar lavage samples obtained from children with covid-19 hospitalized in an iranian children’s hospital. methods: a cross-sectional descriptive study was performed on mini-bronchoalveolar lavage samples from children confirmed positive for covid-19 admitted to icu with a ventilatorfromapril 2021 to february 2022. demographiccharacteristics were recorded, and fungal dna was extracted from mini-bal samples taken from children. nested pcr was made with two primers for aspergillus fumigatus and mucor spp. results: out of 100 children with covid-19, all samples were negative for aspergillus fumigatus; however, 12 cases were positive for bal pcr for mucor spp. among the 12 patients, fever, shortness of breath, cough, and decreased level of consciousness were reported in 8.3% (n: 1), 16.6% (n: 2), 25% (n: 3), and 25% (n: 3), respectively. most cases (41.7%; n: 5) suffered from heart disease, followed by underlying malignancy (33.4%; n: 4). all positive bal pcr for mucor spp. cases had significantly higher chest ct scan scores and spent more time under a ventilator. conclusions: the identification of covid-19 with mucor spp. was observed among 12% (n: 12) of children hospitalized in a covid-19 icu. when dealing with pediatric covid-19 patients, clinicians should consider the differential diagnosis of fungal co-infections and have a low threshold to begin treatment. moreover, it is highly advisable to take prophylactic measures, such as properly using corticosteroids and shortening the intubation time.