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Candida spp. co-infection in COVID-19 patients with severe pneumonia: Prevalence study and associated risk factors

Gonzalo Segrelles-Calvo1, Glauber R de S Araújo2, Estefanía Llopis-Pastor3

  • 1Servicio de Neumología, Hospital Universitario Rey Juan Carlos, Madrid, Spain; Instituto de Investigación Biomédica, Fundación Jiménez Díaz, Madrid, Spain.

Respiratory Medicine
|September 23, 2021
PubMed
Abstract

Insights

Systemic candidiasis affects 14.4% of severe COVID-19 pneumonia patients, leading to worse outcomes. Treatment with tocilizumab may increase the risk of developing invasive fungal infections.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Mycology

Background:

  • Invasive fungal infections (IFI) are rising, with a notable increase in opportunistic mycoses, particularly Aspergillus, in COVID-19 patients.
  • Candida infections have not been widely reported in this population previously.

Purpose of the Study:

  • To determine the prevalence of systemic candidiasis in intensive care unit (ICU) patients with severe pneumonia due to SARS-CoV-2 infection.
  • To identify potential risk factors associated with the development of candidiasis in these patients.

Main Methods:

  • A study was designed involving patients with a confirmed diagnosis of COVID-19.
  • Prevalence of systemic candidiasis and associated risk factors were assessed.

Main Results:

  • Systemic candidiasis was prevalent in 14.4% of patients, with Candida albicans and Candida parapsilosis being the main species identified.
  • Patients with candidiasis experienced longer ICU stays, higher MuLBSTA scores, increased mortality rates, and more severe radiological involvement.
  • Candida spp. were found in patients treated with tocilizumab, systemic steroids, interferon type 1β, and Lopinavir-Ritonavir.

Conclusions:

  • A high prevalence of systemic candidiasis was observed in severe COVID-19-associated pneumonia patients, correlating with poorer clinical outcomes.
  • Tocilizumab treatment may potentially increase the risk of developing systemic candidiasis in this patient group.
Keywords:
COVID-19CandidaSystemic candidiasisViral pneumonia

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