Severe COVID-19 patients in ICU are at high risk for candidemia due to exposure to multiple risk factors for candidemia. We aimed to compare the incidence of candidemia in ICU patients with and without COVID-19, and to investigate epidemiologic and clinical characteristics of candidemia patients and risk factors for mortality in candidemia patients. This retrospective study was conducted in patients followed in the ICUs of Ankara City Hospital for 2 years, divided into pre-pandemic and pandemic periods. The incidence (event per 1000 patient-days) and epidemiology of candidemia, clinical and laboratory characteristics of patients were compared in COVID-19 and non-COVID-19 groups. Candidemia incidence was higher in the COVID-19 group (2.16, 95% CI 1.77–2.60) than the non-COVID-19 group (1.06, 95% CI 0.89–0.125) (p < .001). A total of 236 candidemia episodes (105 in COVID-19 patients and 131 in non-COVID-19 patients) were detected during the study periods. COVID-19 cases had a higher rate of corticosteroid use (63.8% vs. 9.9%, p < .001). Epidemiology of candidemia and antifungal susceptibility were similar. Candidemia developed 2 weeks earlier in COVID-19 groups and resulted in higher mortality (92.5% vs. 79.4%, p .005). One-third of candidemia patients died before receiving any antifungal treatment, and this rate was higher in the COVID-19 group. In multivariate logistic regression analysis, corticosteroid use, presence of sepsis and age older than 65 years were independent risk factors for mortality in candidemia patients. Candidemia with high mortality is a more serious problem for COVID-19 patients due to its increased incidence, earlier occurrence and a higher rate of mortality.

中文翻译：

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COVID-19 患者念珠菌血症的特征；与非 COVID-19 患者相比，发病率更高、发生更早且死亡率更高

由于接触多种念珠菌血症的危险因素，ICU 中的重症 COVID-19 患者发生念珠菌血症的风险很高。我们旨在比较有和没有 COVID-19 的 ICU 患者的念珠菌血症发生率，并调查念珠菌血症患者的流行病学和临床特征以及念珠菌血症患者死亡的危险因素。这项回顾性研究是在安卡拉市医院 ICU 随访 2 年的患者中进行的，分为大流行前和大流行期。在 COVID-19 和非 COVID-19 组中比较了念珠菌血症的发生率（每 1000 患者日的事件）和流行病学、患者的临床和实验室特征。COVID-19 组 (2.16, 95% CI 1.77–2.60) 的念珠菌血症发病率高于非 COVID-19 组 (1.06, 95% CI 0.89–0.125) ( p < .001)。在研究期间共检测到 236 例念珠菌血症事件（COVID-19 患者中 105 例，非 COVID-19 患者中 131 例）。COVID-19 病例的皮质类固醇使用率较高（63.8% 对 9.9%，p  < .001）。念珠菌血症的流行病学和抗真菌药物敏感性相似。念珠菌血症在 COVID-19 组提前 2 周出现并导致更高的死亡率（92.5% 对 79.4%，p.005)。三分之一的念珠菌血症患者在接受任何抗真菌治疗之前就已经死亡，而这一比例在 COVID-19 组中更高。在多变量逻辑回归分析中，皮质类固醇的使用、脓毒症的存在和年龄超过 65 岁是念珠菌血症患者死亡的独立危险因素。高死亡率的念珠菌血症对 COVID-19 患者来说是一个更严重的问题，因为它的发病率增加、发生更早且死亡率更高。