Systematic Review Journal Article Meta-Analysis Ppublish 1 citation
PubMed: 39379339 DOI: 10.1111/myc.13798
Candidemia Following Severe COVID-19 in Hospitalised and Critical Ill Patients: A Systematic Review and Meta-Analysis.
Mycoses 67(10):e13798
Authors: Karan Srisurapanont, Bhoowit Lerttiendamrong, Tanaporn Meejun, Jaedvara Thanakitcharu, Kasama Manothummetha, Achitpol Thongkam, Nipat Chuleerarux, Anawin Sanguankeo, Lucy X Li, Surachai Leksuwankun, Nattapong Langsiri, Pattama Torvorapanit, Navaporn Worasilchai, Rongpong Plongla, Chatphatai Moonla, Saman Nematollahi, Olivia S Kates, Nitipong Permpalung
Affiliations
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Panyananthaphikkhu Cholprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand.
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA.
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, and Research Unit of Medical Mycology Diagnosis, Chulalongkorn University, Bangkok, Thailand.
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
Abstract
RATIONALE
The epidemiology and clinical impact of COVID-19-associated candidemia (CAC) remained uncertain, leaving gaps in understanding its prevalence, risk factors and outcomes.
METHODS
A systematic review and meta-analysis were conducted by searching PubMed, Embase and Scopus for reports of CAC prevalence, risk factors and clinical outcomes up to June 18, 2024. The generalised linear mixed model was employed to determine the prevalence and 95% confidence intervals (CIs). The risk factors and clinical outcomes were compared between patients with and without CAC using the inverse variance method.
RESULTS
From 81 studies encompassing 29 countries and involving 351,268 patients, the global prevalence of CAC was 4.33% (95% Cl, 3.16%-5.90%) in intensive care unit (ICU) patients. In ICUs, the pooled prevalence of CAC in high-income countries was significantly higher than that of lower-middle-income countries (5.99% [95% Cl, 4.24%-8.40%] vs. 2.23% [95% Cl, 1.06%-4.61%], p = 0.02). Resistant Candida species, including C. auris, C. glabrata (Nakaseomyces glabratus) and C. krusei (Pichia kudriavzveii), constituted 2% of ICU cases. The mortality rate for CAC was 68.40% (95% Cl, 61.86%-74.28%) among ICU patients. Several risk factors were associated with CAC, including antibiotic use, central venous catheter placement, dialysis, mechanical ventilation, tocilizumab, extracorporeal membrane oxygenation and total parenteral nutrition. Notably, the pooled odds ratio of tocilizumab was 2.59 (95% CI, 1.44-4.65).
CONCLUSIONS
The prevalence of CAC is substantial in the ICU setting, particularly in high-income countries. Several risk factors associated with CAC were identified, including several that are modifiable, offering the opportunity to mitigate the risk of CAC.
MeSH
Candidiasis, Income, Covid-19, Candidemia, Prevalence, Mycoses, Risk Factors, Intensive Care Units