Kouris Elena Camelia, Mirea Sînziana Irina, Luminos Monica Luminița, Miron Victor Daniel
Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
National Institute of Infectious Diseases "Prof. Dr. Matei Balș", 021105 Bucharest, Romania.
Microorganisms. 2024 Oct 18;12(10):2090. doi: 10.3390/microorganisms12102090.
Oral candidiasis has been documented in patients with SARS-CoV-2 infection, with varying prevalence rates across geographic regions and patient demographics. This study aimed to ascertain the incidence, characteristics, and risk factors associated with the development of oral candidiasis in patients hospitalized for SARS-CoV-2 infection in a tertiary infectious diseases hospital in Romania.
A retrospective analysis was conducted on adult patients hospitalized between March 2020 and December 2022 with moderate or severe forms of SARS-CoV-2 infection, for whom a culture of lingual scrapings for spp. was performed.
A total of 294 patients were deemed eligible for inclusion in the analysis, with an incidence rate of oral candidiasis of 17.0%. The incidence of oral candidiasis was 4.2 times higher in patients with severe forms of SARS-CoV-2 infection compared to those with moderate forms. Patients with a diagnosis of COVID-19 and oral candidiasis were more likely to receive antibiotics (98.0% vs. 86.1%, = 0.017) and corticosteroids (100% vs. 83.6%, = 0.003) than those without oral candidiasis. These findings were associated with a 19% higher relative risk of developing oral candidiasis for patients who received corticosteroid therapy compared to those who did not, and a 13% higher relative risk for those who were administered antibiotics compared to those who were not. The presence of respiratory insufficiency increased the odds of oral candidiasis association 4.7-fold (88.0% vs. 61.1%, < 0.001).
Although the data have been analyzed retrospectively, we have shown that individuals with severe forms of COVID-19 exhibited an elevated risk of developing oral candidiasis. The administration of antibiotics and corticosteroids was identified as a positive predictor for the development of oral candidiasis. The data presented here suggest that a key aspect of the therapeutic management of patients with SARS-CoV-2 infection should include the implementation of preventive measures to minimize the risk of secondary fungal infections.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者中已记录到口腔念珠菌病，不同地理区域和患者人口统计学特征的患病率有所不同。本研究旨在确定罗马尼亚一家三级传染病医院中因SARS-CoV-2感染住院的患者发生口腔念珠菌病的发病率、特征及相关危险因素。
对2020年3月至2022年12月期间因中度或重度SARS-CoV-2感染住院的成年患者进行回顾性分析，对其舌部刮片进行念珠菌属培养。
共有294例患者被认为符合纳入分析的条件，口腔念珠菌病的发病率为17.0%。与中度SARS-CoV-2感染患者相比，重度患者口腔念珠菌病的发病率高4.2倍。诊断为2019冠状病毒病（COVID-19）且患有口腔念珠菌病的患者比未患口腔念珠菌病的患者更有可能接受抗生素治疗（98.0%对86.1%，P = 0.017）和皮质类固醇治疗（100%对83.6%，P = 0.003）。这些发现表明，接受皮质类固醇治疗的患者发生口腔念珠菌病的相对风险比未接受治疗的患者高19%，接受抗生素治疗的患者比未接受治疗的患者高13%。呼吸功能不全的存在使口腔念珠菌病的关联几率增加4.7倍（88.0%对61.1%，P < 0.）。
尽管数据是回顾性分析的，但我们已表明重度COVID-19患者发生口腔念珠菌病的风险升高。抗生素和皮质类固醇的使用被确定为口腔念珠菌病发生的阳性预测因素。此处呈现的数据表明，SARS-CoV-2感染患者治疗管理的一个关键方面应包括实施预防措施以尽量降低继发真菌感染的风险。
