TY - JOUR
T1 - Candida spp. co-infection in COVID-19 patients with severe pneumonia
T2 - Prevalence study and associated risk factors
AU - Segrelles-Calvo, Gonzalo
AU - Araujo, Glauber R. de S.
AU - Llopis-Pastor, Estefania
AU - Carrillo, Javier
AU - Hernandez-Hernandez, Marta
AU - Rey, Laura
AU - Rodriguez Melean, Nestor
AU - Escribano, Ines
AU - Anton, Esther
AU - Zamarro, Celia
AU - Garcia-Salmones, Mercedes
AU - Frases, Susana
PY - 2021/9
Y1 - 2021/9
N2 - Background: Invasive fungal infections (IFI) are increasing in prevalence in recent years. In the last few months, the rise of COVID-19 patients has generated a new escalation in patients presenting opportunistic mycoses, mainly by Aspergillus. Candida infections are not being reported yet.Objectives: We aimed to determine the prevalence of systemic candidiasis in patients admitted to ICUs due to severe pneumonia secondary to SARS-CoV-2 infection and the existence of possible associated risk factors that led these patients to develop candidiasis.Patients/methods: We designed a study including patients with a confirmed diagnosis of COVID-19. Results: The prevalence of systemic candidiasis was 14.4%, and the main isolated species were C. albicans and C. parapsilosis. All patients that were tested positive for Candida spp. stayed longer in the ICU in comparison to patients who tested negative. Patients with candidiasis had higher MuLBSTA score and mortality rates and a worse radiological involvement. In our study, Candida spp. isolates were found in patients that were submitted to: tocilizumab, tocilizumab plus systemic steroids, interferon type 1 beta and Lopinavir-Ritonavir.Conclusions: Results suggested a high prevalence of systemic candidiasis in severe COVID-19-associated pneumonia patients. Patients with Candidiasis had the worst clinical outcomes. Treatment with tocilizumab could potentialize the risk to develop systemic candidiasis.
AB - Background: Invasive fungal infections (IFI) are increasing in prevalence in recent years. In the last few months, the rise of COVID-19 patients has generated a new escalation in patients presenting opportunistic mycoses, mainly by Aspergillus. Candida infections are not being reported yet.Objectives: We aimed to determine the prevalence of systemic candidiasis in patients admitted to ICUs due to severe pneumonia secondary to SARS-CoV-2 infection and the existence of possible associated risk factors that led these patients to develop candidiasis.Patients/methods: We designed a study including patients with a confirmed diagnosis of COVID-19. Results: The prevalence of systemic candidiasis was 14.4%, and the main isolated species were C. albicans and C. parapsilosis. All patients that were tested positive for Candida spp. stayed longer in the ICU in comparison to patients who tested negative. Patients with candidiasis had higher MuLBSTA score and mortality rates and a worse radiological involvement. In our study, Candida spp. isolates were found in patients that were submitted to: tocilizumab, tocilizumab plus systemic steroids, interferon type 1 beta and Lopinavir-Ritonavir.Conclusions: Results suggested a high prevalence of systemic candidiasis in severe COVID-19-associated pneumonia patients. Patients with Candidiasis had the worst clinical outcomes. Treatment with tocilizumab could potentialize the risk to develop systemic candidiasis.
KW - Covid-19
KW - Candida
KW - Systemic candidiasis
KW - Viral pneumonia
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pure_univeritat_ramon_llull&SrcAuth=WosAPI&KeyUT=WOS:000711032600002&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1016/j.rmed.2021.106619
DO - 10.1016/j.rmed.2021.106619
M3 - Article
C2 - 34555702
SN - 0954-6111
VL - 188
JO - Respiratory Medicine
JF - Respiratory Medicine
IS - 106619
M1 - 106619
ER -