ABSTRACT
In New Delhi, India, candidemia affected 15 critically ill coronavirus disease patients admitted to an intensive care unit during April-July 2020. Candida auris accounted for two thirds of cases; case-fatality rate was high (60%). Hospital-acquired C. auris infections in coronavirus disease patients may lead to adverse outcomes and additional strain on healthcare resources.
Subject(s)
Betacoronavirus , Candida , Candidiasis/virology , Coronavirus Infections/microbiology , Cross Infection/microbiology , Pneumonia, Viral/microbiology , Adult , Aged , Antifungal Agents/therapeutic use , COVID-19 , Candidiasis/drug therapy , Candidiasis/epidemiology , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Critical Illness , Cross Infection/drug therapy , Cross Infection/epidemiology , Drug Resistance, Multiple , Female , Humans , India/epidemiology , Male , Microbial Sensitivity Tests , Middle Aged , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , SARS-CoV-2 , COVID-19 Drug TreatmentSubject(s)
Antifungal Agents/pharmacology , Candida/drug effects , Candidiasis/drug therapy , Candidiasis/microbiology , Coronavirus Infections/microbiology , Pneumonia, Viral/microbiology , Antifungal Agents/therapeutic use , Betacoronavirus/isolation & purification , COVID-19 , Candida/isolation & purification , Candidiasis/transmission , Candidiasis/virology , Drug Resistance, Multiple, Fungal , Humans , Pandemics , SARS-CoV-2ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of pneumonia. Nevertheless, it has not been reported as the cause of acute myocarditis or fulminant myocarditis. CASE PRESENTATION: A 63-year-old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as having COVID-19 according to sputum testing on the day of admission. He also had elevated troponin I (Trop I) level (up to 11.37 g/L) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of interleukin-6 was 272.40 pg/ml. Bedside chest radiographs showed typical ground-glass changes indicative of viral pneumonia. Laboratory test results for viruses that cause myocarditis were all negative. The patient conformed to the diagnostic criteria of the Chinese expert consensus statement for fulminant myocarditis. After receiving antiviral therapy and mechanical life support, Trop I was reduced to 0.10 g/L, and interleukin-6 was reduced to 7.63 pg/mL. Moreover, the LVEF of the patient gradually recovered to 68%. The patient died of aggravation of secondary infection on the 33rd day of hospitalization. CONCLUSION: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. This is the first report of COVID-19 complicated with fulminant myocarditis. The mechanism of cardiac pathology caused by COVID-19 needs further study.