Fungal Coinfections in COVID-19-Positive Patients at a Tertiary Care Hospital in Saudi Arabia

Background: Most coronavirus disease 2019 (COVID-19) patients present with mild or moderate severity of the disease. However, disease comorbidities may require mechanical ventilation and intensive care (IC), which predispose COVID-19 patients to secondary opportunistic fungal infections. Objective: An observational retrospective cohort study was conducted to investigate the relationship between fungal coinfections and morbidity and mortality rates in patients with severe COVID-19 admitted to a tertiary hospital in Makkah, Saudi Arabia. Methodology: This work was conducted on 1,220 patients with COVID-19 admitted to a Saudi Tertiary Care Hospital in Makkah city from June 1, 2020, to May 30, 2021, to evaluate the existence of fungal infections. COVID-19 cases were confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR). Statistical analysis was performed via SPSS version 22.0 (IBM, USA). Results: Of the 1,220 included samples, fungal coinfections were detected in 57 (4.7%) patients. Candida albicans was the major isolated strain in 39 (68.4%) patients, and the primary source of infection was sputum (40 patients: 70.2%). Most samples were isolated from the ICU (41 patients; 71.9%); bacteria coinfection was detected in 12 (21%) severely ill patients. Conclusion: Mindfulness of the plausibility of fungal coinfection is important to control infection and ultimately reduces the risk and the delay in diagnostic and treatment process. It will also guide the diagnostic tools in identifying high-risk patients and quickly determine the most appropriate interventions for reducing the possibility of infection besides morbidity and mortality rates.