The Influence of Infection and Colonization on Outcomes in Inpatients With COVID-19: Are We Forgetting Something?

Abstract

The COVID-19 epidemic has been a great challenge to health systems and especially hospitals. A prospective observational epidemiological study was planned as of February 26, 2020 in a tertiary hospital in the Valencia region. The total number of patients followed up with complete information during the first year was 2,448. Among other variables, the comorbidities of the patients were collected (and grouped in the Charson index), the stay in the intensive care unit (ICU), the co-infections, and the colonizations. Data on nosocomial infections due to said virus were also collected. The median days from the onset of symptoms to diagnosis were 4 + 4.6, while an additional 4.4 days had to pass for the patients to be admitted to the ICU. The factors associated with a higher risk of death were those with coinfection, especially with Candida auris [odds ratio (OR): 4.6], a situation that also occurred in the ICU (OR: 3.18). Charlson Index comorbidity and C. auris colonization were also very important both in general hospitalization and in the ICU.

Global prevalence and subgroup analyses of coronavirus disease (COVID‐19) associated Candida auris infections (CACa): A systematic review and meta‐analysis

“…MALDI‐TOF MS successfully detected all 47 eligible C. auris cases (not isolates) (100%) in five studies 42,43,47,49,50 . Prevalence rate for use of this diagnostic method was estimated 97.65% (95% CI: 91.831 to 99.967; I 2 : 0.00%; p value: .9901) (Table 2 and Supplement 42 in Data ).…”

“…In this analysis, 1942 patients were hospitalised with SARS‐CoV‐2, and C. auris was found in 65 patients. One study each was conducted in the U.S, 40 Brazil, 41 Colombia, 42 Spain, 43 Italy, 44 Pakistan 45 and the UAE, 46 and the remaining three studies were conducted in India. 47 , 48 , 49 We reported both percentage and proportion rates.…”

“…The percent rates of CACa cases (by country) in 10 eligible studies were as follows: Colombia 30% (6/20), 42 Brazil 6.38% (3/47), 41 U.S 8.95% (6/67), 40 Italy 5.1% (6/118), 44 Spain 3.85% (14/364), 43 India 2.75% (25/908), 47 , 48 , 49 Pakistan 15.38% (4/26) 45 and the UAE 0.25% (1/392) 46 (Table 2 ). Results of our random‐effects model showed that the overall pooled prevalence of CACa was 5.7% (95% CI: 2.774 to 9.578; I 2 : 88.67%; p value: <.0001) (Table 2 , Supplement 14 in Data S1 , and Figures 2 and 3 ).…”

“…MALDI‐TOF MS successfully detected all 47 eligible C. auris cases (not isolates) (100%) in five studies. 42 , 43 , 47 , 49 , 50 Prevalence rate for use of this diagnostic method was estimated 97.65% (95% CI: 91.831 to 99.967; I 2 : 0.00%; p value: .9901) (Table 2 and Supplement 42 in Data S1 ). Moreover, sequencing of ITS rDNA and D1/D2 regions was used to detect 27 C. auris in 27 eligible cases (100%) in three eligible studies.…”

“…The percent rates of CACa cases (by country) in 10 eligible studies were as follows: Colombia 30% (6/20), 42 Brazil 6.38% (3/47), 41 U.S 8.95% (6/67), 40 Italy 5.1% (6/118), 44 Spain 3.85% (14/364), 43 India 2.75% (25/908), [47][48][49] Pakistan 15.38% (4/26) 45 and the UAE 0.25%…”