Co-infections have an unknown impact on the morbidity and mortality of the new clinical syndrome called coronavirus disease 2019 (COVID-19). The syndrome is caused by the new pandemic coronavirus SARS-CoV-2 and it is probably connected with severe traces in the elements of the immune system. Apart from possible Aspergillus infections, particularly in patients with acute respiratory distress syndrome (ARDS), other fungal infections could occur, probably more easily, due to the immunological dysregulation and the critical condition of these patients. Probiotic preparations of Saccharomyces are broadly used for the prevention of antibiotic-associated complications, especially in the intensive care units (ICU). On the other hand, Saccharomyces organisms are reported as agents of invasive infection in immunocompromised or critically ill patients. We report two cases of bloodstream infection by Saccharomyces in two patients hospitalised in the ICU, due to severe COVID-19, after Saccharomyces supplementation.

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as an important complication among patients with acute respiratory failure due to SARS-CoV-2 infection. Almost 2.5 years since the start of the COVID-19 pandemic, it continues to raise concerns as an extra factor that contributes to increased mortality, which is mostly because its diagnosis and management remain challenging. The present study utilises the cases of forty-three patients hospitalised between August 2020 and February 2022 whose information was gathered from ten ICUs and special care units based in northern Greece. The main aim was to describe the gained experience in diagnosing CAPA, according to the implementation of the main existing diagnostic consensus criteria and definitions, and present the different classification of the clinical cases due to the alternative algorithms.

Background/Objectives: Nasogastric tube insertion is a very common procedure for enteral feeding, hollow viscera decompression and perioperative management. Although generally safe, both insertion and removal are not without complications. Methods: The aim of the present narrative review is to classify, analyze and make comments on the cases of a gastric tube [usually inserted through the nose but in some cases through the mouth] unexpectedly becoming twisted, coiled or self-knotted within the stomach, entangled with the endotracheal tube, entrapped in the suture line of a hollow viscera, or suddenly broken at its end. Results: This review has the particular characteristic that the articles analyzed are simply case reports, and not clinical studies. The literature search revealed 107 cases since 1977, which we classify into 5 categories of complications instead of the four applied to date. All these relatively rare complications are recognized usually only at the time of gastric tube removal and sometimes require emergency manipulation. After meticulous and documented research, we came to the conclusion that the pathogenesis and etiology of self-knotting seem to be different depending on whether or not a patient is endotracheally intubated. To these reports we have added another eight unpublished personal cases, all successfully managed by means of endoscopy. Conclusions: We argue that these complications must always be considered a possibility by the doctors involved, so that, at the slightest suspicion, there is immediate readiness to treat in order to avoid, as far as possible, a more complicated outcome likely to subject the patient to greater risk and may even require the cooperation of specialties to treat it.