ABSTRACT
Introduction: COVID-19 pandemic infection has affected over 650 million people with over 6 million deaths. Critically unwell patients are at increased risk of developing invasive fungal infections [1]. The aim of this study was to identify the number of patients admitted to ICU with COVID-19 who developed fungal infections and to compare these patients (fungal group) with those without fungal infections (non-fungal group) to investigate which factors may have contributed to increased risk of infection. Method(s): Retrospective study undertaken in a tertiary teaching hospital ICU. 174 patients admitted with severe COVID-19 infection during March 2020 until May 2021 were included. Result(s): 81(47%) patients developed fungal infections of which 94% had Candida and 6% had Aspergillus infection. Age and smoking history did not appear to be a contributing factor. The nonfungal group had significantly higher body mass index (33 +/- 8 vs 31 +/- 7, p = 0.01). ICU length of stay [23(1-116) vs 8(1-60), p < 0.001], hospital length of stay [30(3-183) vs 15(1-174) +/- 7, p < 0.001], steroid days [10(1-116) vs 4(0-28), p = 0.02] and ventilation days [18(0-120) vs 2(0-55), p < 0.001] were significantly higher in the fungal group. The mortality rate in both groups were similar (51% vs 51.6%). Conclusion(s): Fungal infections are extremely common in COVID- 19 patients admitted to ICU, seen in almost half of patients in this cohort (47%). Longer treatment with corticosteroids appears to increase the risk of developing fungal infections. Increased length of ICU stay, and a greater length of mechanical ventilation significantly increase the risk of fungal infections in COVID-19 patients in intensive care. Fungal infection, however was not associated with increase in mortality.