Background: There is concern that patients with coronavirus disease 2019 (COVID-19) are at risk of developing secondary bacterial and fungal infections;however, data on the clinical characteristics and outcomes of COVID-19 patients with fungal infections are limited We evaluated the risk factors and mortality of hospitalized COVID-19 patients with fungal infections Methods: This was a retrospective chart review of 51 patients with fungal infections at an 877-bed teaching hospital in Detroit, Michigan from March through May 2020 Demographic data, comorbidities, complications, treatment, and outcomes, including relapse, readmission and mortality were collected We performed a descriptive analysis Results: A total of 51 patients with fungal infections were included, in which 31 (60 8%) had confirmed or suspected COVID-19 infection Of the COVID-19 patients, the average age was 66 years and the majority (54 9%) were female The average length of stay (LOS) was 29 3 days Aspergillus sp (2 A fumigatus, 1 A niger) were isolated in 3 (10%) patients while 23 (74 2%) had candidemia diagnosed via blood culture or T2Candida® Panel One had a positive serum galactomannan The average time from admission to diagnosis was 13 days Significant comorbidities included hypertension (74%), diabetes (51 6%), coronary artery disease (25 8%), congestive heart failure (32 2%), chronic kidney disease (22 6%), and malignancy (16 1%) Most patients received steroids (83 9%) and broad-spectrum antibiotics (80 6%), had a central line (80 6%), and required intensive care unit management (90%) Only 71% were treated with antifungals One patient with candidemia relapsed due to poor source control;two were readmitted within 30 days In-hospital mortality rate was 51 6% among COVID-19 patients Conclusion: COVID-19 patients with fungal infections had multiple comorbidities, prolonged hospitalization and predisposing risk factors for fungal infections with a high in-hospital mortality rate Prevention of fungal infections in COVID-19 patients is paramount
Characteristics and outcomes of COVID-19 patients with fungal infections