Braz J Infect Dis . Increased incidence of candidemia in critically ill patients during the Coronavirus Disease 2019 (COVID-19) pandemic

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Braz J Infect Dis


. 2022 Apr 25;102353.
doi: 10.1016/j.bjid.2022.102353. Online ahead of print.
Increased incidence of candidemia in critically ill patients during the Coronavirus Disease 2019 (COVID-19) pandemic


Matthaios Papadimitriou-Olivgeris ¹ , Fevronia Kolonitsiou ² , Sotiria Kefala ³ , Anastasia Spiliopoulou ² , Diamanto Aretha ³ , Christina Bartzavali ² , Argyro Siapika ² , Markos Marangos ⁴ , Fotini Fligou ³



Affiliations

• PMID: 35500645
• DOI: 10.1016/j.bjid.2022.102353

Abstract

Background: Patients with severe Coronavirus Disease 2019 (COVID-19) are treated with corticosteroids.
Aim: We aimed to evaluate the role of corticosteroid treatment in candidemia development during the COVID-19 pandemic.
Methods: This retrospective study was conducted in a Greek ICU, from 2010 to August 2021, encompassing a pre-pandemic and a pandemic period (pandemic period: April 2020 to August 2021). All adult patients with candidemia were included.
Results: During the study period, 3,572 patients were admitted to the ICU, 339 patients during the pandemic period, of whom 196 were SARS-CoV-2-positive. In total, 281 candidemia episodes were observed in 239 patients, 114 in the pandemic period. The majority of candidemias in both periods were catheter-related (161; 50.4%). The incidence of candidemia in the pre-pandemic period was 5.2 episodes per 100 admissions, while in the pandemic period was 33.6 (p < 0.001). In the pandemic period, the incidence among COVID-19 patients was 38.8 episodes per 100 admissions, while in patients without COVID-19 incidence was 26.6 (p = 0.019). Corticosteroid administration in both periods was not associated with increased candidemia incidence.
Conclusions: A significant increase of candidemia incidence was observed during the pandemic period in patients with and without COVID-19. This increase cannot be solely attributed to immunosuppression (corticosteroids, tocilizumab) of severe COVID-19 patients, but also to increased workload of medical and nursing staff.

Keywords: COVID-19; Candidemia; Corticosteroids; Critically-ill patients; ICU; SARS-CoV-2.