Fungal positivity seen in tertiary care hospital during COVID-19 pandemic.

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has been prevailing for more than a year, associated with an increased number of opportunistic invasive fungal infections in patients who have been critically ill or immunocompromised. In this retrospective study, details of various clinical specimens received from suspected patients of fungal infections were studied. Fungal cultures were positive in 64% (51 out of 79) of COVID-19-positive patients and 43% (163 out of 381) of COVID-19-negative patients during the second wave of COVID-19 in 2021. Among COVID-19-infected patients, the most commonly isolated fungi were Candida spp. (63%), followed by Aspergillus spp. (15%) and Mucor spp. (6%). The majority of samples that tested positive in COVID-19-infected patients were urine (17% from COVID-19-positive and 83% from COVID-19-negative patients), followed by serum (tested for Aspergillus galactomannan). Candida isolation was observed in 27% (21/79) of urine samples and 15% (12/79) of respiratory samples [bronchoalveolar lavage (BAL), tracheal aspirate, and sputum] from COVID-19-positive patients. Rhizopus arrhizus and Rhizopus homothallicus were isolated from nasal and tissue samples in 6% of COVID-19-positive patients. There was an overall increase in fungal co-isolations during the COVID-19 pandemic (64% in COVID-19-positive and 43% in COVID-19-negative patients), which is a matter of great concern. The correlation of clinical symptomatology and laboratory isolation is important for the diagnosis and effective management of these patients.