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Colegio de Medicina Interna de México.

2024, Number 2

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Med Int Mex 2024; 40 (2)

Association between fungal infection and increased mortality in patients with SARSCoV- 2 in an intensive care unit

Santibáñez VM, Medina GG, Ángeles GU, Olguín SE

Language: Spanish
References: 23
Page: 97-106
PDF size: 235.06 Kb.


ABSTRACT

Objective: To determine whether the association of fungal infection increases mortality in patients with SARS-CoV-2 in the intensive care unit.
Materiales and Methods: Cross-sectional and observational retrospective cohort done from April 1st to December 30th 2020 in patients with confirmed report of SARSCoV- 2, both sexes, with age from 16 to 75 years, positive nasopharyngeal PCR test for COVID-19 and assisted mechanical ventilation.
Results: There were included 74 patients, 51 men and 23 women. Median age of 55 and 51 years, respectively. With SOFA score ‹ 9: 19 patients, from 10-11: 36, › 12: 19 patients. SIRA: mild 8, moderate 19 and severe 47 patients. PaO2: median 75%, IQR: 25-137%. The following patients were managed with assisted mechanical ventilation: prone 49 patients and supine 25, FIO2 median 98%, IQR: 45-100% and median PEEP 9 mmHg, RIQ: 5-12 mmHg. ICU stay: median 17.42 and IQR: 10-22 days, p = 0.021. Mortality was 54 patients, of whom 37 were men. Fungal infection: 12 patients with mortality from 9 patients. OR: 1.13, CI: 0.27-4.69, p = 0.862 and (0.353) = 1.226 + 12 (0.024); p = 0.865. Survival 19.5 days, log rank: p = 0.853.
Conclusions: No association was found between fungal coinfection and increased mortality of patients with SARS-CoV-2 with assisted mechanical ventilation.


REFERENCES

  1. Centros para el Control y la Prevención de Enfermedades(CDC). Nuevo coronavirus de 2019 (2019-nCoV), Wuhan,China. Resumen de la situación. Consultado el 19 de enerode 2020. https://www.cdc.gov/coronavirus/2019-nCoV/summary.html.

  2. Informes de situación de la enfermedad por coronavirus(COVID-2019) 19 de enero 2021. https://www.who.int/publications/m/item/weeklyepidemiological-update---19-january-2021.

  3. World Health Organization WHO. Coronavirus disease 2019(COVID-19). Situation Report – 41 Cifras al 01 de marzode 2020. https://www.who.int/docs/defaultsource/coronaviruse/situation-reports/20200301-sitrep-41-covid19.pdf?sfvrsn=6768306d_2.

  4. World Health Organization WHO. Coronavirus Disease(COVID-19) pandemic. https:// www.who.int/emergencies/diseases/novelcoronavirus-2019. Accessed 13 May 2020.

  5. Suárez V, Suarez M, Quezada B, Ruiz A, Ronquillo E. Epidemiologíade COVID-19 en México: del 27 de febrero al 30 deabril de 2020. Rev Clin Esp 2020;220(8):463-471. https://doi.org/10.1016/j.rce.2020.05.007.

  6. Informe técnico diario COVID-19 México. https://coronavirus.gob.mx.

  7. Garcia C, Vidal G, Sanjuan E, Moreno G, Puerta P, GarciaN, et al. Incidence of co-infections and superinfectionsin hospitalized patients with COVID-19: a retrospectivecohort study. Clin Microbiol Infect 2021; 27 (1): 83-88. doi:10.1016/j.cmi.2020.07.041.

  8. Llitjos JF, Bredin S, Lascarrou JB, Soumagne T, Cojocaru M,Leclerc M, et al. Increased susceptibility to intensive careunit-acquired pneumonia in severe COVID-19 patients: amulticenter retrospective cohort study. Ann Intensive Care2021; 11: 20. doi: 10.1186/s13613-021-00812-w.

  9. Messina FA, Marin E, Valerga M, Depardo R, Chediak V,Romero MM, et al. Infecciones fúngicas en pacientes conCOVID19. ASEI Buenos Aires 2021; 29 (105): 9-19.

  10. Nucci M, Barreiros G, Guimarães LF, Deriquehem VAS, CastiñeirasAC, Nouér SA. Increased incidence of candidemia ina tertiary care hospital with the COVID-19 pandemic. Mycoses2020; 00: 1-5. https://doi. org/10.1111/myc.13225.

  11. Calvo GS, Araújo GR, Pastor E, Carrillo J, Hernández M, ReyL, et al. Prevalence of opportunistic invasive aspergillosis inCOVID-19 patients with severe pneumonia. Mycoses 2020;00: 1-8. https://doi.org/10.1111/myc.13219.

  12. Pemán J, Ruiz G, García C, Salavert M, Ramírez P, PuchadesF, et al. Fungal co-infection in COVID-19 patients: Shouldwe be concerned? Rev Iberoam Micol 2020; 37 (2): 41-46.

  13. Rawson TM, Moore LSP, Zhu N, Ranganathan N, SkolimowskaK, Gilchrist M, et al. Bacterial and fungal coinfection inindividuals with coronavirus: A rapid review to supportCOVID-19 Antimicrob Prescribing. Clin Infect Dis 2020; 71(1): 2459-2468.

  14. Chowdhary A, Tarai B, Singh A, Sharma A. MultidrugresistantCandida auris infections in critically i ll coronavirusdisease patients, India, April-July 2020. EmergInfect Dis 2020; 26 (11): 2694-2696. doi: 10.3201/eid2611.203504.

  15. Salehi M, Ahmadikia K, Mahmoudi S, Kalantari S, SiahkaliS.J, Izadi A, et al. Oropharyngeal candidiasis in hospitalizedCOVID-19 patients from Iran: Species identification andantifungal susceptibility pattern. Mycoses 2020; 63 (8):771-778. doi: 10.1111/myc.13137.

  16. Antinori S, Bonazzetti C, Gubertini G, Capetti A, Pagani C,Morena V, et al. Tocilizumab for cytokine storm syndromein COVID-19 pneumonia: An increased risk for candidemia?Autoimmun Rev 2020; 19 (7): 102564. doi: 10.1016/j.autrev.2020.102564.

  17. White PL, Dhillon R, Cordey A, Hughes H, Faggian F, Soni S,et al. A national strategy to diagnose COVID-19 associatedinvasive fungal disease in the ICU. Clin Infect Dis 2021; 73(7): 1634-1644. doi: 10.1093/cid/ciaa1298.

  18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiologicaland clinical characteristics of 99 cases of 2019novel coronavirus pneumonia in Wuhan, China: A descriptivestudy. Lancet 2020; 395 (10223): 507-513. https://doi.org/10.1016/S0140-6736(20)30211-7.

  19. Ángeles-Garay U, Velázquez-García JA, Hernández-González C, Velázquez-Chávez Y, Hernández-Flores NG,Portilla-Aguilar M, et al. Factores asociados a defunciónen pacientes hospitalizados por COVID-19. Rev Med InstMex Seguro Soc 2021; 59 (5): 423-30.

  20. Rhodes A, Evans LE, Alhazzani W, Levy M, Antonelli M,Ferrer R, et al. Surviving Sepsis Campaign: InternationalGuidelines for Management of Sepsis and Septic Shock:2016. Intensive Care Med 2017; 43 (3): 304-377.

  21. Carrillo-Esper R, Sánchez-Zúñiga MJ, Medveczky-OrdóñezN, Carrillo-Córdova DM. Evolución de la definición delsíndrome de insuficiencia respiratoria aguda. Med Int Méx2018; 34 (4): 594-600.

  22. Secretaría de Salud. Norma Oficial Mexicana NOM-012-SSA3-2012, que establece los criterios para la ejecución deproyectos de investigación para la salud en seres humanos.{Internet}. México. Nuevas reformas publicadas en el DOF19-02-2021. Citado 2023 junio 22. http://www.diputados.gob.mx/LeyesBiblio/pdf/142_190221.pdf.

  23. Reglamento de la Ley General de Salud en Materia deInvestigación para la salud. Nuevo reglamento publicadoen el Diario Oficial de la Federación del 06 enero de 1987,última reforma publicada DOF 02-04-2014 {Internet}.México Citado 2023 junio 22. http://www.diputados.gob.mx/LeyesBiblio/pdf/142_010616.pdf




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