Some COVID-19 patients have gastrointestinal

[zakiyatasnim]

Some patients with COVID-19 are at risk of secondary fungal infections due to weakened cellular immunity caused by viral infections, glucocorticoids and/or broad-spectrum antibiotics. Microbiological examination of respiratory secretions, such as smear preparation and culture for severely ill patients, should be performed; and D-glucose (G test) and galactomannan (GM test) of blood or bronchoalveolar lavage fluid should be tested in a timely manner for suspected patients.

Vigilance is required for possible invasive candidal infection and antifungal therapy. Fluconazole or an echinocandin may be used in the following conditions:

patients take broad-spectrum antibiotics for seven or more days;
patients are receiving parenteral nutrition; patients are undergoing invasive examination or treatment;
patients have a positive Candida culture in a sample obtained from two or more body parts;
patients with significantly elevated G-test results.
Vigilance is needed for possible invasive pulmonary aspergillosis. Antifungal drugs such as voriconazole, posaconazole, or an echinocandin may be used in the following conditions:

patients take glucocorticoids for seven or more days;
patients experience agranulocytosis;
in patients with chronic obstructive pulmonary disease and israel number data a positive Aspergillus culture in a respiratory tract specimen;
patients with significantly elevated G-test results.
IX. Balance of intestinal microecology and nutritional support

symptoms (e.g. abdominal pain and diarrhea) due to direct viral infection of the intestinal mucosa or the use of antiviral and anti-infective drugs. It has been noted that the intestinal microecological balance is disturbed in COVID-19 patients, which is manifested by a significant decrease in the content of intestinal probiotics such as lactobacilli and bifidobacteria. Intestinal microecological imbalance can lead to bacterial translocation and secondary infection, so it is important to maintain the balance of intestinal microecology with microecological modulator and nutritional support.

1 Microecological intervention

Microecological preparations can reduce bacterial translocation and secondary infection. They can increase the number of dominant intestinal bacteria, suppress harmful intestinal bacteria, reduce the production of toxins, and reduce infection caused by intestinal microflora dysbacteriosis.
Microecological preparations can improve the gastrointestinal symptoms of patients. They can reduce the amount of water in the stool, improve the nature of the stool and the frequency of defecation, and reduce diarrhea by suppressing the atrophy of the intestinal mucosa.
A hospital with appropriate resources can conduct an analysis of intestinal flora. Thus, the disturbance of intestinal flora can be detected at an early stage based on the results obtained. Antibiotics can be adjusted in a timely manner and probiotics can be prescribed. This can reduce the likelihood of intestinal bacterial translocation and intestinal infection.
Nutritional support is an important mechanism for maintaining the intestinal microecological balance. Intestinal nutritional support should be applied in a timely manner based on an effective assessment of nutritional risks, gastrointestinal function, and aspiration risks.