Severe cases of coronavirus disease 2019 (COVID-19) managed in the intensive care unit are prone to complications, including secondary infections with opportunistic fungal pathogens. Systemic fungal co-infections in hospitalized COVID-19 patients may exacerbate COVID-19 disease severity, hamper treatment effectiveness and increase mortality. Here, we reiterate the role of fungal co-infections in exacerbating COVID-19 disease severity as well as highlight emerging trends related to fungal disease burden in COVID-19 patients. Furthermore, we provide perspectives on the risk factors for fungal co-infections in hospitalized COVID-19 patients and highlight the potential role of prolonged immunomodulatory treatments in driving fungal co-infections, including COVID-19-associated pulmonary aspergillosis (CAPA), COVID-19-associated candidiasis (CAC) and mucormycosis. We reiterate the need for early diagnosis of suspected COVID-19-associated systemic mycoses in the hospital setting.

In this contribution, we report on the possibility that cryptococcal protease(s) could activate the SARS-CoV-2 spike (S) protein. The S protein is documented to have a unique four-amino-acid sequence (underlined, SPRRAR↓S) at the interface between the S1 and S2 sites, that serves as a cleavage site for the human protease, furin. We compared the biochemical efficiency of cryptococcal protease(s) and furin to mediate the proteolytic cleavage of the S1/S2 site in a fluorogenic peptide. We show that cryptococcal protease(s) processes this site in a manner comparable to the efficiency of furin (p > 0.581). We conclude the paper by discussing the impact of these findings in the context of a SARS-CoV-2 disease manifesting while there is an underlying cryptococcal infection.

Catheter-associated urinary tract infections (CAUTIs) are among the most common nosocomial infections globally and represent a significant cause of morbidity and prolonged hospital stays. There is a scarcity of molecular data regarding pathogens and virulence factors linked to CAUTIs, particularly in South Africa. This study aimed to determine the distribution and frequency of uropathogens, including polymicrobial infection patterns, isolated from catheterised patients at the Polokwane National Health Laboratory Services (NHLS), Limpopo Province, from March 2024 to March 2025, and to characterise the prevalence and co-occurrence of six virulence genes (fimH, papC, sfa, hly, cnf, and aer) among Escherichia coli isolates, the predominant uropathogen identified. Specimens from catheterised patients diagnosed with urinary tract infections at the National Health Laboratory Services in Polokwane were used. Uropathogens were isolated on agar and identified using the VITEK^® system. Polymerase chain reaction (PCR) was used for amplification of some virulence genes (fimH, papC, sfa, hly, cnf, and aer) associated with uropathogens. Confirmation of urinary tract infections revealed that Escherichia coli was the predominant uropathogen (32.8%), followed by Klebsiella pneumoniae (17.8%), Enterococcus faecalis, Enterococcus faecium (14%), and others. Among E. coli isolates, virulence gene analysis revealed fimH (79.8%) as the most prevalent, followed by aer (77.4%), sfa (41.7%), hly (27.4%), papC (26.19%), and lastly cnf (9.5%). This study demonstrates that E. coli is the leading cause of CAUTIs in our study population, exhibiting diverse virulence gene combinations that enhance adhesion and overall pathogenicity. The findings emphasise the need for routine molecular surveillance of CAUTI pathogens, reinforcement of catheter-care protocols, and targeted infection prevention strategies.