The first detection of Pneumocystis jirovecii in asthmatic patients post-COVID-19 in Jordan

Ahmad Riyad Alsayed; Wamidh  Talib; Abdullah  Al-Dulaimi; Safa  Daoud; Mohammed  Al Maqbali

doi:10.17305/bjbms.2022.7335

Authors

Ahmad Riyad Alsayed Department of Clinical Pharmacy and Therapeutic, Applied Science Private University, Amman, Jordan https://orcid.org/0000-0002-1324-7884
Wamidh Talib Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
Abdullah Al-Dulaimi Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
Safa Daoud Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
Mohammed Al Maqbali Department of Nursing Midwifery and Health, Northumbria University, Newcastle-Upon-Tyne, UK

DOI:

https://doi.org/10.17305/bjbms.2022.7335

Keywords:

Asthma, COVID-19, developing country, Pneumocystis jirovecii, polymerase chain reaction

Abstract

Pneumocystis jirovecii pneumonia (PCP), caused by fungal species named Pneumocystis jirovecii, is a frequent opportunistic infection in those with human immunodeficiency virus (HIV) infection. However, PCP has been documented in immunocompetent patients. This study aims to determine if P. jirovecii detection occurs in asthma patients following coronavirus disease 2019 (COVID-19) in a Jordanian cohort. Also, to evaluate a method of TaqMan quantitative polymerase chain reaction (qPCR) assay to detect P. jirovecii, from sputum samples. The nasopharyngeal swabs were used to detect SARS-CoV-2 and sputum samples were tested for P. jirovecii using real time qPCR assay. Beta-tubulin (BT) and Dihydrofolate reductase (DHFR) genes were the directed targets of P. jirovecii. The results showed that the mean qPCR efficiencies of BT and DHFR were 96.37% and 100.13%, respectively. Three out of 31 included patients (9.7%) had a positive P. jirovecii. All of the three patients had used oral corticosteroids (OCS) in the last two months due asthma exacerbation and were treated with OCS for COVID-19. This is the first study based in Jordan to demonstrate that P. jirovecii and COVID-19 can co-exist and that it is important to maintain a broad differential diagnosis, especially in immunocompromised patients. Chronic lung disease can be a risk factor for the P. jirovecii colonization possibly due to corticosteroid's immunosuppression.