Table 4.
Candida infections in COVID-19 patients treated with steroids.
| Literature | Trial Design | CS Used | CS Length | Other IST | Comorbidities/ Risk Factors |
Candida Infection Incidence | Time to CAC Dx | Mortality |
|---|---|---|---|---|---|---|---|---|
| Antinori et al. [112] Italy |
n = 43 severe COVID-19 pts; 3/43 candidemia | NM | NM | Toci | TPN (3/3), antibiotics (2/3), toci (3/3) |
6.9% BSI | Toci last dose—CAC: med 13 ds | Still hospitalized on publication |
| Chowdhary et al. [97] India |
n = 596 COVID-19 ICU pts, 420 MV, 15 Candida BSI | NM | NM | NM | ↑ ICU LOS, HTN, DM, CKD, CS (10/15) | 2.5% BSI | Admis-CAC: 10–12 ds |
53% (60% for C. auris) |
| Ho et al. [98] USA |
R, O, n = 4313 hospitalised, 574 (13.3%) received CS | MP > P > dexa | 6.34–9.53 ds | Toci | HTN 35.4% DM23.4% CKD 13% |
BSI | NM | |
| Obata et al. [95] USA |
R, 226 COVID-19 hosp pts, 57 on CS vs. 169 no-CS | See Table 1 | Max 10ds | 20/57 Toci | NM | CAC in CS vs. no-CS: 7% vs. 0% CAC in toci vs. no-toci: 15% vs. 2.7% |
NM | NM |
| Riche et al. [96] Brazil |
R, candidemia incidence between COVID and non-COVID inpatients | MP > dexa > P | 2–13 ds | No | HD CS CVC 90.9% ICU pts (72.7%) |
×10 increase in candidemia | ICU admis-CAC: 0–22 ds | 72.7% following CS use |
| Seagle et al. [36] USA |
Candidemia in COVID-19 and non-COVID-19 pts, surveillance data | NM | NM | Toci more likely among pts with COVID-19 compared to non-COVID-19 pts | Candidemia RF in non-COVID pts: LD, malignancy, prior surgeries CAC each >1.3 times more common: ICU, MV, CVC, CS, IST. Common RF in COVID-19 pts: DM, obesity. |
CS within 30 ds of CAC: ×2 vs. non-COVID-19 pts | SARS-CoV-2 (+) test-Candida culture: med 15 ds ([IQR]: 8–21 days) | CAC: ×2 mortality (62.5%) vs. candidemia in non-COVID-19 pts (32.1%) |
| Segrelles-Calvo [114] et al. Spain |
O, P, n = 218 ICU pts | MP | 1–10 ds | Toci-CAC: RR 1.378, p = 0.05. Toci + MP/dexa (p = 0.01) |
Malignancies more common in COVID-19 with candida co-infection. ICU, TPN, CVC, ↑LO ICU stay |
14.4% (+) Candida tests |
N = number, admis = admission, ARF = Acute Renal Failure, BAS = Bronchial aspirate, BSI = Blood-stream infections, BW = body weight, CFR = Case Fatality Rate, CS = corticosteroids, CRD = Chronic Respiratory Disease, cumul = cumulative, CVD = cardiovascular disease, DL = dyslipidemia, Ds = days, dexa = dexamethasone, DM = diabetes mellitus, Dx = diagnosis, ECMO = Extra-corporeal membrane oxygenation, GM = galactomannan, GM = Galactomannan, GMI = galactomannan index, HD = high dose, HTN = Hypertension, IA = Invasive Aspergillosis, IFI = invasive fungal infection, intub = intubation, IST = immunosuppressive therapy, MC = Multicenter, med = median, MN = multi-national, MP = methylprednisolone, MV = mechanically ventilated, m = median, n = number of patients, NA = not applicable, NM = not mentioned, O = observational, OR = odds Ratio, P = Prospective, prev = previous, prob = probable, put = putative, R = Retrospective, resp sampl on deterior = respiratory sampling on deterioration, ROM = Rhino-orbital mucormycosis, saril = sarilumab, SC = single center, Sx = symptom, Toci = tocilizumab, unclass = unclassified.