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Candida Bloodstream Infection, a Dire Complication in Hospitalized COVID-19 Patients: Three Cases from a Single
Shay Brikman1,2,3, Guy Dori1,2,3, Carmel Kasher4
1Internal Medicine Ward E, Emek Medical Center, Afula, Israel.
Insights
Severe COVID-19 patients can develop Candida bloodstream infections (candidemia). This study found a higher incidence of candidemia in COVID-19 patients, with all three cases resulting in death.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Severe coronavirus disease-2019 (COVID-19) increases susceptibility to secondary infections.
- Superimposed fungal infections pose a significant risk to critically ill COVID-19 patients.
Observation:
- A retrospective study identified three COVID-19 patients with Candida bloodstream co-infection (candidemia) at a single center in Israel.
- The study period coincided with the second COVID-19 outbreak in Israel (June-September 2020).
Findings:
- All three COVID-19 patients with candidemia experienced fatal outcomes shortly after diagnosis.
- Three distinct Candida species (C. albicans, C. parapsilosis, C. glabrata) were identified.
- The incidence of candidemia among hospitalized COVID-19 patients was 0.679 episodes per 1000 hospital days, appearing higher than historical controls.
Implications:
- Clinicians managing COVID-19 patients, particularly in intensive care units, must be vigilant for candidemia.
- Early recognition and management of candidemia may be crucial for improving outcomes in severe COVID-19.
- Further research is needed to understand the increased risk and optimal treatment strategies for candidemia in COVID-19 patients.
Background:
Patients with severe coronavirus disease-2019 (COVID-19) are susceptible to superimposed infections.
Objectives:
To describe COVID-19 patients who presented with complications due to Candida bloodstream co-infection (candidemia) and their outcome in a single center in northern Israel (Emek Medical Center) during the second outbreak of COVID-19 in Israel (15 June 2020 to 20 September 2020).
Methods:
A retrospective study of COVID-19 patients presenting with candidemia was conducted, including clinical and laboratory data. The incidence of candidemia among hospitalized COVID-19 patients was compared to a historical cohort of non-COVID-19 controls.
Results:
Three COVID-19 patients complicated with candidemia were documented. All three patients died shortly after the detection of candidemia. Three different Candida sp. were isolated from the blood cultures: C. albicans, C. parapsilosis, and C. glabrata. The incidence of candidemia among COVID-19 patients was 0.679 episodes per 1000 hospital days.
Conclusions:
Our small sample suggests a much higher incidence of candidemia among COVID-19 patients compared to a historical cohort of non-COVID-19 controls. All clinicians treating COVID-19 patients in GICU should be aware of this complication.
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