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Mortality of Patients With Candidemia and COVID-19: A Systematic Review With Meta-analysis
Marta Colaneri1,2, Emanuele Maria Giusti3, Camilla Genovese1,4
1Department of Clinical Sciences, Infectious Diseases and Immunopathology, Università di Milano, L. Sacco Hospital, Milan, Italy.
Insights
Patients with candidemia (a fungal infection) and coronavirus disease 2019 (COVID-19) face high mortality rates. Early screening for candidemia is crucial to prevent this life-threatening condition in COVID-19 patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Candidemia occurrence in coronavirus disease 2019 (COVID-19) patients is noted but mortality is understudied.
- Fungal infections, like candidemia, may pose a significant threat to critically ill COVID-19 patients.
Purpose of the Study:
- To systematically review and meta-analyze the mortality and length of stay for COVID-19 patients with candidemia.
- To summarize existing evidence on the outcomes of candidemia in the context of COVID-19.
Main Methods:
- Systematic review and meta-analysis of 26 articles from 1915 retrieved records.
- Pooled analysis of in-hospital, all-cause, 30-day mortality, and length of stay data.
- Subgroup analyses were conducted to explore heterogeneity.
Main Results:
- Pooled in-hospital mortality for candidemia in COVID-19 patients was 62.62%.
- Pooled intensive care unit (ICU) mortality was 66.77%.
- Median in-hospital length of stay was 30.41 days, and ICU length of stay was 28.28 days.
Conclusions:
- Patients with both candidemia and COVID-19 exhibit high mortality rates.
- The findings underscore the need for proactive screening and prevention strategies for candidemia in COVID-19 patients.
- Further research may be needed to identify sources of heterogeneity in outcomes.
Abstract:
Mortality of candidemia in coronavirus disease 2019 (COVID-19) patients has not been deeply studied despite evidence suggesting an increased occurrence. We performed a systematic review and meta-analysis to summarize the available evidence about these patients' mortality and length of stay. Data about the in-hospital, all-cause and 30-day mortality, and length of stay were pooled. Subgroup analyses were performed to assess sources of heterogeneity. Twenty-six articles out of the 1915 records retrieved during the search were included in this review. The pooled in-hospital mortality was 62.62% (95% CI, 54.77% to 69.86%), while the mortality in intensive care unit (ICU) was 66.77% (95% CI, 57.70% to 74.75%). The pooled median in-hospital length of stay was 30.41 (95% CI, 12.28 to 48.55) days, while the pooled median length of stay in the ICU was 28.28 (95% CI, 20.84 to 35.73) days. The subgroup analyses did not identify the sources of heterogeneity in any of the analyses. Our results showed high mortality in patients with candidemia and COVID-19, suggesting the need to consider screening measures to prevent this life-threatening condition.
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