Evaluation of candidemia cases in the intensive care unit of a tertiary training hospital during the period of COVID-19 pandemic

Abstract

Background Many risk factors, including COVID-19 infection, lead to the development of invasive Candida infection in intensive care unit patients. The aim of this study was to evaluate the risk factors affecting mortality along with the clinical characteristics of candidemia patients. Methods This retrospective study was conducted among patients hospitalized at the Anesthesiology and Reanimation Clinic between June 2020 and December 2021. The clinical and laboratory characteristics of 165 patients with candidemia were recorded. The difference between patients with and without COVID-19 infection was evaluated statistically. Multivariate analysis was performed to determine factors affecting mortality. Results A total of 165 patients were included in the study, 52.1% of whom were male. The mean age of the patients was 66.5 (median 18-97) years. The percentage of patients with COVID-19 infection was 70.9%. The mean leukocyte count and aspartate transaminase, alanine transaminase, C-reactive protein, lactate dehydrogenase, ferritin, and D-dimer levels were significantly greater in COVID-19 patients than non COVID-19 patients (p < 0.05). The mortality rate in patients with candidemia was 80.2%. The presence of comorbidities, corticosteroid use, advanced age, and high ferritin and D-dimer levels negatively affected mortality, according to the multivariate analysis results. C. albicans was the most frequently isolated Candida species. Conclusions We detected higher mortality rates in patients with candidemia who were elderly, had comorbidities, received corticosteroid treatment and had elevated ferritin and D-dimer levels. When steroids are used, it is necessary to remember that this drug is a double-edged sword and to be careful of fungal infections.