Candidemia in Coronavirus Disease 2019 (COVID-19) Patients: Incidence and Characteristics in a Prospective Cohort Compared With Historical Non–COVID-19 Controls

A retrospective multicenter analysis of candidaemia among COVID-19 patients during the first UK pandemic wave

“…Here, we report our experience with candidaemia co-infection with COVID-19. An increased incidence of candidaemia has been noted in patients with COVID-19 and although patient characteristics, investigations and antifungal therapies have been described ( 2 ), to our knowledge, compliance with candidaemia management bundles has not ( 3 ).…”

“… Demographics N=11 Age, years Sex, male 62 (33-77) 10 (90.9%) Past medical history Type 2 diabetes Hypercholesterolaemia Hypertension Ischaemic Heart Disease Permanent Pacemaker Myaesthenia Gravis Previous solid organ malignancy Gastro-oesophageal Reflux Disease Benign prostatic hypertrophy Hypopituitarism 8 (72.7 %) 8 (72.7%) 3 (27.3%) 1 (9.1%) 1 (9.1%) 1 (9.1%) 2 (18.2%) 1 (9.1%) 1 (9.1%) 1 (9.1%) Risk factors for candidaemia Immunosuppression Broad spectrum antimicrobials Neutropenic Intensive care (ICU) admission Intravenous catheter Average catheter day Number of patients where catheter day unknown Ventilated Inotropic support Haemofiltration Urinary catheter Total parenteral nutrition Candida colonisation Yes No Unknown 2 (18.2%) a 11 (100%) 0 (0%) 10 (90.9%) 10 (90.9%) 6.3 ( 3 , 4 , 5 , 6 , 7 , 8 , 9 ) 4 (40%) 10 (90.9%) 10 (90.9%) 9 (81.8) 11 (100%) 0 (0%) 4 5 2 Clinical course Days to candidaemia since COVID-19 diagnosis Days to candidaemia since ICU admission Repeat blood cultures taken at 48 hours Days to candidaemia clearance Non-albicans candidaemia Beta-D-glucan performed positive negative Galactomannan performed positive negative Intravascular catheter removed culture confirmation of same Candida spp. Echocardiogram performed positive negative Fundoscopy peformed positive negative Death at 30 days 14.8 ( 7 -24) 15.5 ( 6 -24) 6 (54.5%) 2.3 ( 1 , 2 , 3 ) 4 (36.4%) 6 (54.5%) 3 (50%) b 3 (50%) 5 (45.5%) 0 (0%) 5 (100%) ...…”

Increased incidence of candidemia in a tertiary care hospital with the COVID‐19 pandemic

“…A series of 989 patients with COVID‐19 admitted to a hospital in Spain reported four cases of candidemia among 88 coinfections and superinfections 8 . Another series from Italy reported 21 cases of candidemia in patients with COVID‐19 and found a higher incidence of candidemia in COVID‐19 patients compared with a historical cohort 9 …”

Costocondritis y espondilitis diferidas por Candida en paciente post-COVID-19 tratado previamente con corticoides, antibióticos y tocilizumab

“… 3 , 4 Aunque no está del todo demostrado si los pacientes con COVID-19 tienen una incidencia de infecciones por Candida spp. mayor que otros pacientes, algunos trabajos recientes sugieren que presentan un riesgo mayor de candidemia que otras cohortes retrospectivas no-COVID-19 5 . Además de los factores de riesgo conocidos para el desarrollo de una candidemia en pacientes ingresados en una UCI, debe tenerse en cuenta que la frecuente combinación de fármacos inmunosupresores (corticoides), antibióticos de amplio espectro y de inhibidores del receptor de la interleucina-6 (IL-6), en pacientes con infecciones graves por SARS-CoV-2 puede aumentar el riesgo de infecciones nosocomiales por Candida spp.…”

“…No está clara si la incidencia de candidemia en pacientes con COVID-19 es mayor que en otros grupos de pacientes, aunque algunos trabajos recientes sugieren que en pacientes con COVID-19, la candidemia es más frecuente que en cohortes históricas no-COVID-19 5 . Los pacientes con infección grave por SARS-CoV-2 ingresados en la UCI presentan muchos de los factores de riesgo asociados para desarrollar una candidemia, pero se desconoce si su incidencia es mayor o menor que en otros grupos de pacientes 9 .…”