FUNGAL COMPLICATIONS WITH THE NEW CORONAVIRUS INFECTION COVID-19

The aim of the study was to determine the predisposing factors for the development of fungal complications in the new coronavirus infection COVID-19 based on the analysis of the frequency of isolation of fungal cultures and the characteristics of patients with these complications.Methods. The results of a bacteriological study of 1284 cultures from sputum samples of patients with COVID-19 were considered. The study included 404 cultures of various types of fungi. Analysis of the clinical picture was carried out in 70 patients with fungal complications: Candida ssp. (64 patients) and fungi (Aspergillus ssp. and Mucor ssp - 5 patients). The outcome of the disease: favorable - 66, lethal - 4.Results. During the two years of the pandemic, the proportion of fungal cultures increased from 26.9% in 2020 to 34.2% in 2021, while maintaining sensitivity to amphotericin and fluconazole. In 2021, there was a negative growth trend in the sputum of molds of the species Aspergillus spp (5 cultures) and Mucor spp (1 culture).Typical fungal complications of COVID-19 were: oropharyngeal candidiasis caused by Candida albicans (71%), urinary tract candidiasis (20%), lung damage of mixed viral-fungal etiology (34%). Only fungal flora was isolated in 57.1% of cases, various combinations of fungal and bacterial flora - in 42.9%. Risk factors for the development of localized forms of fungal complications are the age of patients older than 50 years, overweight, hypertension, uncontrolled use of antibiotics and glucocorticosteroids at the prehospital stage. Localized mycoses are recorded in both severe and moderate COVID-19. An additional factor in their development is immunosuppressive therapy of the underlying disease. The most formidable complication of the course of COVID-19, worsening the prognosis of survival, is the addition of fungi with invasive growth - Aspergillus spp., Mucor, as well as the development of fungal-bacterial associations with damage to the lung tissue.Conclusion. In the context of the ongoing SARS-CoV-2 pandemic, the use of immunomodulatory agents, including the combined use of corticosteroids and targeted immunosuppressive drugs, it is important to develop a risk-based approach in diagnosis and treatment for patients at risk of generalized and invasive mycoses.