Comparison of candidemia patient profile in COVID-19 and non-COVID-19 cases in a tertiary hospital in Surabaya, Indonesia

Abstract

The COVID-19 pandemic has been linked to secondary infections. Candidemia, a fungal healthcare-associated infection, has been described in patients hospitalized with severe COVID-19. Risk factors for developing severe COVID-19 include older age, malignancies, obesity, immunocompromised conditions, and chronic diseases, many of which are also risk factors for candidemia. This study aimed to compare clinical characteristics of candidemia in patients with and without COVID-19. This retrospective study observe patients medical records from 2020 – 2021 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. A total of 131 candidemia cases (23 COVID-19 patients and 108 non-COVID-19 patients) were included during the study periods. COVID-19 cases had a higher rate of diabetes (60,9%, p=0,00), pulmonary disease (87%, p=0,00), obesity (34,8%, p=0,00), and having urinary catheter (69,6%, p=0,00). Non-albicans candida was the most common agent of candidemia in non-COVID-19 patients (91,3%, p=0,03). The susceptibility of fluconazole (80,6 v 56,5, p=0,01), caspofungin (82,4 v 60,9, p=0,04), amphotericin B (90,7 v 78,3, p=0,03) and flucytosine (92,6 v 73,9, p=0,00) were higher in non-COVID-19 patients. Based on the study result, it is important to take measures to prevent the transmission of Candida spp. with lower antifungal sensitivity that cause candidemia in COVID-19 patients.