Mycoses . Morbidity and mortality of hospitalized patients with candidemia during the various severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic waves: A multicenter evaluation of 248 United States hospitals

[tetano]

Mycoses


. 2023 Feb 5.
doi: 10.1111/myc.13573. Online ahead of print.
Morbidity and mortality of hospitalized patients with candidemia during the various severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic waves: A multicenter evaluation of 248 United States hospitals


Karri A Bauer ¹ , Kalvin Yu ² , Pamela A Moise ¹ , Lyn Finelli ¹ , ChinEn Ai ² , Janet Watts ² , Gang Ye ² , Vikas Gupta ²



Affiliations

• PMID: 36740751
• DOI: 10.1111/myc.13573

Abstract

Background: Studies evaluating outcomes of COVID-19 patients with candidemia are limited and have only evaluated a single timepoint during the pandemic.
Objectives: Compare the prevalence and outcomes associated with candidemia in patients based on SARS-CoV-2 status and through the various pandemic waves (March 1, 2020-March 5, 2022).
Patients/methods: Multicenter, retrospective cohort analysis of data from 248 United States medical facilities using the BD Insights Research Database (Becton, Dickinson and Company, Franklin Lakes, New Jersey, USA). Eligible patients were adults aged ≥18 years who were hospitalized for >1 day, had a SARS-CoV-2 test, and a positive blood culture for Candida spp.
Results: During the study time frame, there were 2,402,879 hospital admissions; 234,903 (9.7%) and 2,167,976 (90.3%) patients were SARS-CoV-2 positive and negative, respectively. A significantly higher rate of candidemia/1,000 admissions was observed in SARS-CoV-2 positive patients compared to SARS-CoV-2 negative patients (3.18 vs. 0.99; P<0.001). The highest candidemia rate for SARS-CoV-2 positive patients was observed during the Alpha SARS-CoV-2 wave (June 2020-August 2020) with the lowest candidemia rate during the Omicron wave. Hospital mortality was significantly higher in SARS-CoV-2 positive patients compared to SARS-CoV-2 negative patients with candidemia (59.6% vs. 30.8%; P<0.001). When evaluating the mortality rate through the various pandemic waves, the rate for the overall population did not change.
Conclusions: Our study indicates high morbidity and mortality for hospitalized patients with COVID-19 and candidemia which was consistent throughout the pandemic. Patients with COVID-19 are at an increased risk for candidemia; importantly, the magnitude of which may differ based on the circulating variant.