Candidemia Following Severe COVID-19 in Hospitalised and Critical Ill Patients: A Systematic Review and Meta-Analysis
Issued Date
2024-10-01
Resource Type
eISSN
14390507
Scopus ID
2-s2.0-85206034325
Pubmed ID
39379339
Journal Title
Mycoses
Volume
67
Issue
10
Rights Holder(s)
SCOPUS
Bibliographic Citation
Mycoses Vol.67 No.10 (2024) , e13798
Suggested Citation
Srisurapanont K., Lerttiendamrong B., Meejun T., Thanakitcharu J., Manothummetha K., Thongkam A., Chuleerarux N., Sanguankeo A., Li L., Leksuwankun S., Langsiri N., Torvorapanit P., Worasilchai N., Plongla R., Moonla C., Nematollahi S., Kates O., Permpalung N. Candidemia Following Severe COVID-19 in Hospitalised and Critical Ill Patients: A Systematic Review and Meta-Analysis. Mycoses Vol.67 No.10 (2024) , e13798. doi:10.1111/myc.13798 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101652
Title
Candidemia Following Severe COVID-19 in Hospitalised and Critical Ill Patients: A Systematic Review and Meta-Analysis
Author's Affiliation
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Chulalongkorn University
King Chulalongkorn Memorial Hospital
University of Arizona College of Medicine – Tucson
Jackson Memorial Hospital
Faculty of Medicine, Chulalongkorn University
Johns Hopkins University School of Medicine
Srinakharinwirot University
Faculty of Medicine, Chiang Mai University
Chulalongkorn University
King Chulalongkorn Memorial Hospital
University of Arizona College of Medicine – Tucson
Jackson Memorial Hospital
Faculty of Medicine, Chulalongkorn University
Johns Hopkins University School of Medicine
Srinakharinwirot University
Corresponding Author(s)
Other Contributor(s)
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.