Table 1.

Details of 10 patients with post-COVID-19 Pneumocystis jirovecii pneumonia

Case #	1	2	3	4	5	6	7	8	9	10
Age, gender	71, M	70, M	62, M	76, M	67, F	69, M	61, F	40, M	50, M	28, F
Comorbid conditions	Diabetes, hypertension, HIV status unknown	Hypertension, ischemic heart disease, Parkinson’s, BPH, HIV status unknown	Diabetes, hypertension, HIV status unknown	None, HIV status unknown	Diabetes, HIV status unknown	Diabetes, Hypertension, ischemic heart disease, chronic kidney disease, upper GI bleed, purpura fulminans, HIV status unknown	Hypertension, rheumatoid arthritis, breast cancer survivor, HIV status unknown	Diabetes mellitus, HIV status unknown	Diabetes mellitus, mantle cell lymphoma, chemotherapy (COVID pneumonia followed by PJP pneumonia 1 year back)	Acute myeloid leukaemia
Treatment for COVID	Tocilizumab, methylprednisolone	Remdesivir, tocilizumab, dexamethasone	Remdesivir, tocilizumab, dexamethasone	Methylprednisolone, remdesivir	Remdesivir, tocilizumab, dexamethasone	No treatment for COVID	Remdesivir, dexamethasone	Remdesivir, dexamethasone	Remdesivir, dexamethasone	No treatment for COVID
Course of hospitalization due to COVID	Condition improved and was discharged from hospital on day 13 with 1 week of oral systemic steroids	Condition partially stabilized, he left against medical advice on day 12 after admission on tapering doses of steroids	Course complicated with intubation at day 17. Remained admitted to hospital	Course complicated with intubation at day 14. Remained admitted to hospital	Course complicated with intubation at day 7. Remained admitted to hospital	Non-severe/ non- critical COVID with no hospitalization followed by repeated hospital admissions monthly for shortness of breath, deranged creatinine and haemodialysis	Severe COVID with need for supplemental oxygen. Condition improved and was discharged from hospital on day 6 with 1 week of oral systemic steroids	Course complicated with intubation on day 2 of admission followed by development of pneumothorax. Patient left against medical advice in critical condition	Course complicated with intubation on day 17 of admission followed by development of pneumothorax. Patient left against medical advice in critical condition	Non-severe/ non- critical COVID with no hospitalization
Duration from COVID to PJP (days)	48	56	18	23	8	180	133	18	18	36
Complaints related to PJP	Readmitted with shortness of breath and hypoxia	Readmitted with high-grade fever and shortness of breath	Worsening hypoxia	Worsening hypoxia	Worsening hypoxia	Readmitted with worsening hypoxia, respiratory distress and worsening metabolic acidosis	Readmitted with hypoxemic respiratory failure	Worsening hypoxia	Hypoxemic respiratory failure	Fever, shortness of breath and cough
Radiology	Bilateral patchy ground-glass opacities more marked in middle and lower zones. Some small cysts were also present in bilateral lower zones	Bilateral alveolar infiltrates more in mid and lower zones. Left lower lobe consolidation. Bilateral small central cysts were also present in lower zones	Bilateral diffuse ground-glass opacities, lower lobe small central cysts and consolidation, pneumomediastinum, pneumopericardium	Bilateral ground glass opacities more in lower lobes, pulmonary embolism involving subsegmental branches of bilateral pulmonary arteries	Bilateral airspace shadowing/alveolar infiltrates, more marked on right side	Bilateral non-homogenous alveolar infiltrates with bilateral mild pleural effusions	Subpleural ground-glass haziness and consolidation in bilateral lung fields along with emphysematous changes in the left upper and apical segment of left lower lobe	Bilateral non-homogenous alveolar infiltrates more in the right lower lung zone. Pneumomediastinum and subcutaneous emphysema predominantly on left side	Diffuse patchy ground-glass opacification and consolidation in bilateral lower lobes	BL lower lobe ground glass opacities that were denser at lung bases. Some small nodules and cysts also present in the same area
LDH (IU l−1)	297	303	410	421	445	Not performed	428	418	228	435
Lymphocyte count in the week of PJP (cells μl−1)	661.2	521.4	472.5	344	375	446.5	646	324	199.8	1472
Type of ventilation	Not done	Invasive	Invasive	Invasive	Invasive	Invasive	Not done	Invasive	Invasive	–
Serum BDG (pg ml−1)	252.3	405.9	352	395	45.621	70.682	Not done	167.885	523	<7.812
Serum GMI	0.141	0.12	0.014	3.789	0.185	0.11	Not done	1.011	0.552	0.174
BAL GMI	0.26	0.33	3.13	Not done	Not done	Not done	0.144	Not done	Not done	0.38
Other microbiological findings (infection/colonization)	Staphylococcus aureus in BAL (infection) BAL TB culture Xpert: negative	Not performed	Aspergillus flavus in BAL (infection)	Multidrug-resistant Acinetobacter spp., Paecilomyces spp. and Hormonema spp. in tracheal culture (infection), carbapenem-resistant Escherichia coli in blood (infection)	Multidrug-resistant Acinetobacter spp. tracheal aspirate and blood (infection)	Stenotrophomonas maltophilia in tracheal aspirate (colonization)	Not performed	Multidrug-resistant Acinetobacter spp., Aspergillus niger, Aspergillus fumigatus and Aspergillus terreus in tracheal culture (infection)	A. flavus, A. niger in tracheal culture (infection), positive CMV PCR (infection)	Acinetobacter and Staphylococcus species in blood culture (infection)
Antibiotics	Piperacillin/tazobactam, co-trimoxazole	Meropenem, vancomycin	Piperacillin/tazobactam, meropenem, vancomycin, co-trimoxazole	Meropenem, colistin, vancomycin, co-trimoxazole	Meropenem, colistin, vancomycin, tigecycline, co- trimoxazole	Meropenem, vancomycin, colistin, co-trimoxazole	Co-trimoxazole	Colistin, co-trimoxazole	Meropenem, colistin, co-trimoxazole	Azithromycin, meropenem, vancomycin, colistin, co-trimoxazole
Antifungals	Voriconazole (200 mg q12 h−1)	Amphotericin-B (50 mg q24 h−1)	Voriconazole (200 mg q12 h−1)	Voriconazole (200 mg q12 h−1)	Voriconazole (200 mg q12 h−1)	Antifungals not given	Antifungals not given	Voriconazole (200 mg q12 h−1)	Voriconazole (200 mg q12 h−1)	Amphotericin-B (40 mg q24 h−1)
Outcome	Discharged	Died	Died	Died	Died	Discharged	Discharged	Discharged	Discharged	Improved and discharged

BDG, beta-D-glucan; GMI, galactomannan index; TB culture, Mycobacterium tuberculosis culture; BPH: benign prostatic hyperplasia.