Infections caused by Candida spp. in patients with COVID-19: A literature review
DOI:
https://doi.org/10.56511/JIPBS.2022.v9.i01.pp07-16Abstract
Objectives: This review aimed to evaluate the frequency of infections caused by yeasts of Candida spp. in patients affected with COVID-19. Materials and methods: A literature review was carried out in the Pubmed, Medline and Scielo databases, using the following keywords: Candida spp.” AND “COVID 19” AND “Candidiasis” AND “Candida”. The selected studies present data about the types of infection, fungal isolates and the treatment employed. Results: There is an increase in mortality rates in individuals co-infected with COVID-19 and Candida spp., especially in those with associated risk factors. The most frequent species were Candida albicans, C. glabrata, C. tropicalis and C. auris. Furthermore, candidemia and oropharyngeal candidiasis were the clinical forms mentioned in association with COVID-19. Management is also dependent on the clinical form and the classes of antifungal agents recommended and/or tested in these studies are azoles, echinocandins and polyenes. Conclusion: Co-infection by Candida spp. and COVID-19 leads to a worrying scenario in which the number of cases has increased around the world, causing higher mortality rates in these patients. This increase was evident throughout the study, as well as emphasizyng the importance of correct identification and management of these infections
Keywords:
Candida spp., Candidiasis, COVID-19, Sars-CoV-2Downloads
References
WHO. Coronavirus disease (COVID - 19) pandemic. Available in https://www.who.int/emergencies/diseases/novel - coronavirus - 2019 . Access in May 27, 2021.
Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS - CoV - 2) and coronavirus disease - 2019 (COVID - 19): The epidemic and the challenges. Int J Antimicrob Agents. 2020; 55(3):105924.
Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID - 19) implicate special control measures. J Med Virol. 2020; 92(6):568 - 576.
Pemán J, Ruiz - Gaitán A, García - Vidal C, et al. Fungal co - infection in COVID - 19 patients: Should we be concerned?. Rev Iberoam Micol. 2020; 37(2):41 - 46.
Yang W, Cao Q, Qin L, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID - 19):A multi - center study in Wenzhou city, Zhejiang, China. J Infect. 2020; 80(4):388 - 393.
Arastehfar A, Carvalho A, Nguyen MH, et al. COVID - 19 - Associated Candidiasis (CAC): An Underestimated Complication in the Absence of Immunological Predispositions?. J Fungi (Basel). 2020; 6(4):2118.
Ni Y, Alu A, Lei H, et al. Immunological perspectives on the pathogenesis, diagnosis, prevention and treatment of COVID -
Brito PBS, Braga I, Moraes M, et al . Mechanisms immunopathological factors involved in SARS - CoV - 2 infection. J. Bras. Pathol. Med. Lab. 2020; 56 .
Thomsen K, Pedersen HP, Iversen S, et al . Extensive microbiological respiratory tract specimen characterization in criticall y ill COVID - 19 patients. APMIS. 2021; 129(7):431 - 437.
Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS - CoV - 2 pneumonia in Wuhan, China: a single - centered, retrospective, observational study [published correction appears in Lancet Respir Med. 2020 Apr;8(4):e26]. Lancet Respir Med. 2020;8(5):475 - 481.
Zuo T, Zhan H, Zhang F, et al. Alterations in Fecal Fungal Microbiome of Patients With COVID - 19 During Time of Hospitalization until Discharge. Gastroenterology. 2020; 159(4):1302 - 1310.e5.
Hughes S, Troise O, Donaldson H, Mughal N, Moore LSP. Bacterial and fungal coinfection among hospitalized patients with COVID - 19: a retrospective cohort study in a UK secondary - care setting. Clin Microbiol Infect. 2020; 26(10):1395 - 1399.
Arastehfar A, Shaban T, Zarrinfar H, et al. Candidemia among Iranian Patients with Severe COVID - 19 Admitted to ICUs. J Fungi (Basel). 2021; 7(4):280.
Nucci M, Barreiros G, Guimarães LF, Deriquehem VAS, Castiñeiras AC, Nouér SA. Increased incidence of candidemia in a tertiary care hospital with the COVID - 19 pandemic. Mycoses. 2021; 64(2):152 - 156.
Mastrangelo A, Germinario BN, Ferrante M, et al. Candidemia in Coronavirus Disease 2019 (COVID - 19) Patients: Incidence and Characteristics in a Prospective Cohort Compared With Historical Non - COVID - 19 Controls. Clin Infect Dis. 2021; 73(9):e2838 - e2839.
White PL, Dhillon R, Healy B, Wise MP, Backs M. Reply to Rodriguez et al and Mastrangelo et al . Clin Infect Dis. 2021;73(9):e2839 - e2841.
Silva DL, Lima CM, Magalhães VCR, et al . Fungal and bacterial coinfections increase mortality of severely ill COVID - 19 patients. J Hosp Infect. 2021; 113:145 - 154.
Cultrera R, Barozzi A, Libanore M, et al . Co - Infections in Critically Ill Patients with or without COVID - 19: A Comparison of Clinical Microbial Culture Findings. Int J Environ Res Public Health. 2021; 18(8):4358.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507 - 513.
Song G, Liang G, Liu W. Fungal Co - infections Associated with Global COVID - 19 Pandemic: A Clinical and Diagnostic Perspective from China. Mycopathologia. 2020; 185(4):599 - 606.
Calderaro A, Buttrini M, Montecchini S, et al. Detection of SARS - CoV - 2 and Other Infectious Agents in Lower Respiratory Tract Samples Belonging to Patients Admitted to Intensive Care Units of a Tertiary - Care Hospital, Located in an Epidemic Area, during the Italian Lockdown. Microorganisms. 2021; 9(1):185.
Thomsen K, Pedersen HP, Iversen S, et al. Extensive microbiological respiratory tract specimen characterization in critically ill COVID - 19 patients. APMIS. 2021 129(7):431 - 437.
Macauley P, Epelbaum O. Epidemiology and Mycology of Candidaemia in non - oncological medical intensive care unit patients in a tertiary center in the United States: Overall analysis and comparison between non - COVID - 19 and COVID - 19 cases. Mycoses. 2021; 64(6):634 - 640.
Kayaaslan B, Eser F, Kaya Kalem A, et al . Characteristics of candidemia in COVID - 19 patients; increased incidence, earlier occurrence and higher mortality rates compared to non - COVID - 19 patients. Mycoses. 2021; 64(9):1083 - 1091.
Arastehfar A, Shaban T, Zarrinfar H, et al. Candidemia among Iranian Patients with Severe COVID - 19 Admitted to ICUs. J Fungi (Basel). 2021; 7(4):280.
Riche CVW, Cassol R, Pasqualotto AC. Is the Frequency of Candidemia Increasing in COVID - 19 Patients Receiving Corticosteroids?. J Fungi (Basel). 2020; 6(4):286.
Chowdhary A, Tarai B, Singh A, Sharma A. Multidrug - Resistant Candida auris Infections in Critically Ill Coronavirus Disease Patients, India, April - July 2020. Emerg Infect Dis. 2020; 26(11):2694 - 2696.
CDC. Candida auris. Available in https://www.cdc.gov/fungal/candida - auris/index.html . Access in May 27, 2021.
Villanueva - Lozano H, Treviño - Rangel RJ, González GM, et al . Outbreak of Candida auris infection in a COVID - 19 hospital in Mexico [published online ahead of print, 2021 Jan 8]. Clin Microbiol Infect. 2021; 27(5):813 - 816.
Schelenz S, Hagen F, Rhodes JL, et al . First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrob Resist Infect Control. 2016; 5:35.
Eyre DW, Sheppard AE, Madder H, et al . A Candida auris Outbreak and Its Control in an Intensive Care Setting. N Engl J Med. 2018; 379(14):1322 - 1331.
Armstrong PA, Rivera SM, Escandon P, et al . Hospital - Associated Multicenter Outbreak of Emerging Fungus Candida auris, Colombia, 2016. Emerg Infect Dis. 2019; 25(7):1339 - 1346.
Alfouzan W, Ahmad S, Dhar R, et al . Molecular Epidemiology of Candida Auris Outbreak in a Major Secondary - Care Hospital in Kuwait. J Fungi (Basel). 2020; 6(4):307.
Chakrabarti A, Singh S. Multidrug - resistant Candida auris: an epidemiological review. Expert Rev Anti Infect Ther. 2020; 18(6):551 - 562.
Nobrega de Almeida J Jr, Brandão IB, Francisco EC, et al. Axillary Digital Thermometers uplifted a multidrug - susceptible Candida auris outbreak among COVID - 19 patients in Brazil. Mycoses. 2021; 64(9):1062 - 1072.
Magnasco L, Mikulska M, Giacobbe DR, et al . Spread of Carbapenem - Resistant Gram - Negatives and Candida auris during the COVID - 19 Pandemic in Critically Ill Patients: One Step Back in Antimicrobial Stewardship?. Microorganisms. 2021; 9(1):95.
Baba Y, Sato Y, Owada G, Minakuchi S. Effectiveness of a combination denture - cleaning method versus a mechanical method: comparison of denture cleanliness, patient satisfaction, and oral health - related quality of life. J Prosthodont Res. 2018; 62(3):353 - 358. .
Azevedo JS, Azevedo MS, Oliveira LJC, Correa MB, Demarco FF. Uso e necessidade de prótese dentária em idosos brasileiros segundo a Pesquisa Nacional de Saúde Bucal (SBBrasil 2010): prevalências e fatores associados [Needs for dental prostheses and their use in elderly Brazilians according to the National Oral Health Survey (SBBrazil 2010): prevalence rates and associated factors]. Cad Saude Publica. 2017; 33(8):e00054016.
Salerno C, Pascale M, Contaldo M, et al. Candida - associated denture stomatitis. Med Oral Patol Oral Cir Bucal. 2011; 16(2):e139 - e143.
Jerônimo LS, Esteves Lima RP, Suzuki TYU, Discacciati JAC, Bhering CLB. Oral Candidiasis and COVID - 19 in Users of Removable Dentures: Is Special Oral Care Needed? [published online ahead of print, 2021 Apr 14]. Gerontology. 2021; 1 - 6 .
Salehi M, Ahmadikia K, Mahmoudi S, et al . Oropharyngeal candidiasis in hospitalised COVID - 19 patients from Iran: Species identification and antifungal susceptibility pattern. Mycoses. 2020; 63(8):771 - 778.
Akpan A, Morgan R. Oral candidiasis. Postgrad Med J. 2002; 78(922):455 - 459.
Iranmanesh B, Khalili M, Amiri R, Zartab H, Aflatoonian M. Oral manifestations of COVID - 19 disease: A review article. Dermatol Ther. 2021; 34(1):e14578.
Gasparoto TH, de Oliveira CE, Vieira NA, et al . The pattern recognition receptors expressed on neutrophils and the associated cytokine profile from different aged patients with Candida - related denture stomatitis. Exp Gerontol. 2012; 47(9):741 - 748.
Powderly WG, Mayer KH, Perfect JR. Diagnosis and treatment of oropharyngeal candidiasis in patients infected with HIV: a critical reassessment. AIDS Res Hum Retroviruses. 1999; 15(16):1405 - 1412.
Nadagir SD, Chunchanur SK, Halesh LH, Yasmeen K, Chandrasekhar MR, Patil BS. Significance of isolation and drug susceptibility testing of non - Candida albicans species causing oropharyngeal candidiasis in HIV patients. Southeast Asian J Trop Med Public Health. 2008; 39(3):492 - 495.
Rajendra Santosh AB, Muddana K, Bakki SR. Fungal Infections of Oral Cavity: Diagnosis, Management, and Association with COVID - 19 [published online ahead of print, 2021 Mar 27]. SN Compr Clin Med. 2021; 1 - 12.
Lv L, Gu S, Jiang H, et al . Gut mycobiota alterations in patients with COVID - 19 and H1N1 infections and their associations with clinical features. Commun Biol. 2021; 4(1):480.
Zuo T, Zhang F, Lui GCY, et al. Alterations in Gut Microbiota of Patients With COVID - 19 During Time of Hospitalization. Gastroenterology. 2020; 159(3):944 - 955.e8.
Zuo T, Zhan H, Zhang F, et al . Alterations in Fecal Fungal Microbiome of Patients With COVID - 19 During Time of Hospitalization until Discharge. Gastroenterology. 2020; 159(4):1302 - 1310.e5.
Juneja D, Nasa P, Singh O, et al . Candida score: a predictor of mortality in patients with candidemia. India Critical Care. 2012; 16(3):17.
Ahmed A, Azim A, Baronia AK, et al . Risk prediction for invasive candidiasis. Indian journal of critical care medicine. Indian Society of Critical Care Medicine, 2014; 18(10):682 - 688.
León C, Ruiz - Santana S, Saavedra P, et al . A bedside scoring system ("Candida score") for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Criticalcare medicine, 2006; 34(3):730 - 737.
Published
How to Cite
Issue
Section
Copyright (c) 2022 M. Silva Fiorio, C. G. dos Santos do Nascimento, P. Abreu Pereira, B. Cervinski Junges, S. Krolow, V. Marcon Giudice, F. Costa Charles, L. Cervieri Mezzomo, S. M. Spalding, L. Noal Calil, A. Mezzari
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Journal of Innovations in Pharmaceutical and Biological Sciences is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Based on a work at