High prevalence of Candida species in the respiratory tract of patients diagnosed with SARS-CoV-2.

Coinfection and secondary infection by fungi in patients with viral pulmonary infection, especially SARS-CoV-2, are important factors that worsen the prognosis and are associated to increased death rates. This work aims to report the prevalence of Candida isolates in bronchoalveolar and nasopharyngeal samples from suspected COVID-19 patients in the first-second pandemic waves and their antifungal resistance profile. From 2,321 patients, 29.04 % were diagnosed with SARS-CoV-2 infection. The yeast isolation rate of 6.97 % (47/674) from positive SARS-CoV-2 was statistically higher than 4.43% (73/1647) from negative SARS-CoV-2 patients (p=0.0177). Among yeasts, the most prevalent species was Candida albicans (63/120), with four being azole-resistant isolates (6.35%); however other emerging and less susceptible species were also isolated, such as Candida guilliermondii (11), Candida glabrata (5), Candida lusitaniae (4), Candida krusei (1), and Candida norvegensis (1). Here, we highlighted Candida prevalence in respiratory tract, emphasizing the relevance for surveillance in SARS-CoV-2/COVID patients for improvement of management as well as patient outcomes.