Acute Heart Failure due to Pulmonary Aspergillus Fumigatus and Cryptococcus Neoformans Infection Associated with COVID-19

BACKGROUND: Current studies have reported that it is rare for the coronavirus disease 2019 (COVID-19) to be combined with two fungal infections and that COVID-19 can be combined with multiple cardiovascular complications, both of which can complicate the condition and increase the risk of death. METHODS: We report a case of COVID-19 in which Aspergillus fumigatus and Cryptococcus neoformans were detected by sputum targeted next-generation sequencing (tNGS) and cardiac monitoring during treatment revealed cardiovascular complications. RESULTS: We consider that this patient's fungal infection was associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the application of corticosteroids. In addition, cardiovascular complications were associated with an inflammatory response and increased sympathetic stimulation due to SARS-CoV-2 infection. CONCLUSIONS: The presence of COVID-19-associated fungal infections cannot be excluded when multiple risk factors for fungal infections are present in patients with COVID-19 and the condition is rapidly deteriorating. Effective long-term monitoring of cardiac function during the patient's hospitalization is necessary to reduce morbidity and mortality.