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Introduction <p>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.</p> Methods <p>Single-center retrospective study assessing IFD in patients with COVID-19, hospitalized for ≥ 72&#xa0;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.</p> Results <p>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&#xa0;days; <i>p</i> &lt; 0.001); increased rates of mechanical ventilation (99% vs. 70%; <i>p</i> &lt; 0.001); and a higher risk of in-hospital death (69% vs. 36%; <i>p</i> &lt; 0.001). On multivariable analysis, COVID-associated fungal infections were associated with an increased risk of in-hospital mortality.</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年1月21日

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

摘要

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.