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J Intensive Med . Severe Candida infections in critically ill patients with COVID-19

tetano

Editor, Senior Moderator
J Intensive Med


. 2023 Sep 2;3(4):291-297.
doi: 10.1016/j.jointm.2023.07.005. eCollection 2023 Oct 31. Severe Candida infections in critically ill patients with COVID-19

Despoina Koulenti[SUP] 1 2 [/SUP], Marios Karvouniaris[SUP] 3 [/SUP], Elisabeth Paramythiotou[SUP] 1 [/SUP], Nikolaos Koliakos[SUP] 1 [/SUP], Nikolaos Markou[SUP] 4 [/SUP], Paschalis Paranos[SUP] 5 [/SUP], Joseph Meletiadis[SUP] 5 [/SUP], Stijn Blot[SUP] 2 6 [/SUP]



Affiliations
Abstract

The frequency of co-infections with bacterial or fungal pathogens has constantly increased among critically ill patients with coronavirus disease 2019 (COVID-19) during the pandemic. Candidemia was the most frequently reported invasive fungal co-infection. The onset of candidemia in COVID-19 patients was often delayed compared to non-COVID-19 patients. Additionally, Candida invasive infections in COVID-19 patients were more often linked to invasive procedures (e.g., invasive mechanical ventilation or renal replacement therapy) during the intensive care stay and the severity of illness rather than more "classic" risk factors present in patients without COVID-19 (e.g., underlying diseases and prior hospitalization). Moreover, apart from the increased incidence of candidemia during the pandemic, a worrying rise in fluconazole-resistant strains was reported, including a rise in the multidrug-resistant Candida auris. Regarding outcomes, the development of invasive Candida co-infection had a negative impact, increasing morbidity and mortality compared to non-co-infected COVID-19 patients. In this narrative review, we present and critically discuss information on the diagnosis and management of invasive fungal infections caused by Candida spp. in critically ill COVID-19 patients.

Keywords: Antifungals; COVID-19; Candida auris; Candida spp.; Candidiasis; Critical illness.

 
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