Evidence of anti-Hcp100 antibodies in COVID-19 critically ill patients with detectable anti-histoplasmin antibodies in a highly endemic area for histoplasmosis

• Published in: Medical mycology (Oxford) Vol. 61; no. 6
• Main Authors: Toscanini, María A, Barberis, Fernanda, Benedetti, Fernanda, Rodríguez Laboccetta, Carolina, Videla Garrido, Agustín, Fernández Briceño, Víctor, Posse, Gladys B, Capece, Paula, Nusblat, Alejandro D, Cuestas, María L
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 05-06-2023
• Subjects: Animals; Antibodies, Fungal; Antigens, Fungal; COVID-19 - veterinary; Critical Illness; Histoplasma; Histoplasmin; Histoplasmosis - diagnosis; Histoplasmosis - epidemiology; Histoplasmosis - microbiology; Histoplasmosis - veterinary; SARS-CoV-2; anti-Hcp100 antibodies; histoplasmosis; severe respiratory failure; COVID-19-associated mycoses
• ISSN: 1369-3786; 1460-2709
• DOI: 10.1093/mmy/myad055

Abstract
Patients with severe COVID-19 are at increased risk for invasive fungal infections, which are underestimated. Histoplasmosis reactivation in endemic areas should not be overlooked in this population. In a previous study, seroconversion to anti-histoplasmin antibodies by ELISA was detected in 6/39 (15.4%) patients with severe COVID-19. In this work, samples were further investigated to detect seroconversion to antibodies against the Histoplasma capsulatum 100-kDa antigen (Hcp100) by ELISA. Seroconversion to anti-Hcp100 antibodies was detected in 7/39 patients, of whom 6 also seroconverted anti-histoplasmin antibodies. These results reinforce previous findings that show histoplasmosis as an underdiagnosed fungal entity complicating COVID-19.
Lay Summary
This study verifies that patients with severe COVID-19 at intensive care units are at risk for histoplasmosis reactivation in endemic areas. Accurate diagnosis of this deadly fungal disease among critically ill patients with COVID-19 living in endemic areas for histoplasmosis is needed.