Epidemiology of Coronavirus Disease 2019-Associated Fungal Infections in the Intensive Care Unit: A Single-Center Retrospective Study.

IF 3.6 3区生物学 Q2 MYCOLOGY

Mycopathologia Pub Date : 2025-01-21 DOI:10.1007/s11046-025-00928-8

Jessica S Little, Gerald McGwin, Lisa Tushla, Kaitlin Benedict, Meghan M Lyman, Mitsuru Toda, John W Baddley, Peter G Pappas

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引用次数: 0

Abstract

Introduction: Invasive fungal disease (IFD) is a morbid superinfection that can arise in critically ill patients with COVID-19 infection. Studies evaluating the full spectrum of COVID-19-associated fungal infections remain limited.

Methods: Single-center retrospective study assessing IFD in patients with COVID-19, hospitalized for ≥ 72 h in the intensive care unit (ICU) between 02/25/20 and 02/28/22 (n = 1410). IFD was assessed using consensus criteria (EORTC/MSGERC or ISHAM/ECMM criteria). T- and chi-square tests compared demographic/clinical characteristics between IFD and non-IFD patients. Cox proportional hazards regression estimated risk factors for in-hospital mortality.

Results: Of 1410 patients with severe COVID-19, 70 (5%) had a diagnosis of COVID-19-associated fungal infection with invasive candidiasis occurring in 3%, and invasive aspergillosis in 2%. Other fungal infections were rare. Patients with IFD had longer ICU stays (26 vs. 13 days; p < 0.001); increased rates of mechanical ventilation (99% vs. 70%; p < 0.001); and a higher risk of in-hospital death (69% vs. 36%; p < 0.001). On multivariable analysis, COVID-associated fungal infections were associated with an increased risk of in-hospital mortality.

Conclusions: This real-world study of critically ill patients with COVID-19 demonstrated a low incidence of COVID-19-associated fungal infections with invasive candidiasis occurring most frequently. Fungal infections were associated with an increased risk of in-hospital mortality in this population.

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重症监护病房冠状病毒病2019相关真菌感染流行病学：一项单中心回顾性研究

侵袭性真菌病（IFD）是一种可在COVID-19感染危重患者中出现的病态重复感染。评估covid -19相关真菌感染全谱的研究仍然有限。方法：采用单中心回顾性研究，评估20年2月25日至22年2月28日期间在重症监护病房（ICU）住院≥72小时的COVID-19患者的IFD （n = 1410）。IFD采用共识标准（EORTC/MSGERC或ISHAM/ECMM标准）进行评估。T检验和卡方检验比较了IFD和非IFD患者的人口学/临床特征。Cox比例风险回归估计了住院死亡率的危险因素。结果：1410例重症COVID-19患者中，70例（5%）诊断为COVID-19相关真菌感染，其中侵袭性念珠菌病占3%，侵袭性曲霉病占2%。其他真菌感染很少见。IFD患者在ICU的停留时间更长(26天vs. 13天；p结论：这项对COVID-19危重患者的现实世界研究表明，COVID-19相关真菌感染的发生率较低，侵袭性念珠菌病最常见。真菌感染与该人群住院死亡风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mycopathologia 生物-真菌学

CiteScore

6.80

自引率

3.60%

发文量

审稿时长

3 months

期刊介绍： Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.