COVID-19 and candiduria: an investigation of the risk factors and immunological aspects
Abstract Secondary fungal infections are frequently observed in COVID-19 patients. However, the occurrence of candiduria in these patients and its risk factors are underexplored. We evaluated the risk factors of candiduria in COVID-19 patients, including inflammatory mediators that could be used as prognostic markers. Clinical information, laboratory test results, and outcomes were collected from severely ill COVID-19 patients with and without candiduria. Candida species identification, antifungal susceptibility, and plasma inflammatory mediators’ measurements were performed. Regression logistic and Cox regression model were used to evaluate the risk factors. A higher risk of longer hospitalization and mortality were observed in patients with candiduria compared to those with COVID-19 only. Candiduria was caused by Candida albicans, C. glabrata, and C. tropicalis. Isolates with intermediate susceptibility to voriconazole and resistant to caspofungin were identified. Classic factors such as the use of corticosteroids and antibacterials, the worsening of renal function, and hematological parameters (hemoglobin and platelets) were found to predispose to candiduria. The mediators IL-1β, IL-1ra, IL-2, CXCL-8, IL-17, IFN-γ, basic FGF, and MIP-1β were significantly increased in patients with COVID-19 and candiduria. Furthermore, IFN-γ, IL-1ra, and CXCL-8 were associated with the occurrence of candiduria in COVID-19 patients, whereas basic FGF, IL-1β, and CXCL-8 were associated with the risk of death in these patients. Classical and immunological factors were associated with worse prognosis among patients with COVID-19 and candiduria. Some mediators, especially CXCL-8, can be a reliable biomarker of fungal coinfection and may guide the diagnostic and the treatment of these patients..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Brazilian journal of microbiology - 54(2023), 3 vom: 05. Juli, Seite 1783-1793 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Singulani, Junya L. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Anmerkungen: |
© The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s42770-023-01042-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2145458123 |
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| 520 | |a Abstract Secondary fungal infections are frequently observed in COVID-19 patients. However, the occurrence of candiduria in these patients and its risk factors are underexplored. We evaluated the risk factors of candiduria in COVID-19 patients, including inflammatory mediators that could be used as prognostic markers. Clinical information, laboratory test results, and outcomes were collected from severely ill COVID-19 patients with and without candiduria. Candida species identification, antifungal susceptibility, and plasma inflammatory mediators’ measurements were performed. Regression logistic and Cox regression model were used to evaluate the risk factors. A higher risk of longer hospitalization and mortality were observed in patients with candiduria compared to those with COVID-19 only. Candiduria was caused by Candida albicans, C. glabrata, and C. tropicalis. Isolates with intermediate susceptibility to voriconazole and resistant to caspofungin were identified. Classic factors such as the use of corticosteroids and antibacterials, the worsening of renal function, and hematological parameters (hemoglobin and platelets) were found to predispose to candiduria. The mediators IL-1β, IL-1ra, IL-2, CXCL-8, IL-17, IFN-γ, basic FGF, and MIP-1β were significantly increased in patients with COVID-19 and candiduria. Furthermore, IFN-γ, IL-1ra, and CXCL-8 were associated with the occurrence of candiduria in COVID-19 patients, whereas basic FGF, IL-1β, and CXCL-8 were associated with the risk of death in these patients. Classical and immunological factors were associated with worse prognosis among patients with COVID-19 and candiduria. Some mediators, especially CXCL-8, can be a reliable biomarker of fungal coinfection and may guide the diagnostic and the treatment of these patients. | ||
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Candiduria | |
| 650 | 4 | |a Pro-inflammatory cytokines | |
| 650 | 4 | |a CXCL-8 | |
| 650 | 4 | |a Mortality | |
| 700 | 1 | |a Silva, Danielle L. |4 aut | |
| 700 | 1 | |a Lima, Caroline M. |4 aut | |
| 700 | 1 | |a Magalhães, Vanessa C. R. |4 aut | |
| 700 | 1 | |a Baltazar, Ludmila M. |4 aut | |
| 700 | 1 | |a Moura, Alexandre S. |4 aut | |
| 700 | 1 | |a Santos, Ana Raquel O. |4 aut | |
| 700 | 1 | |a Fereguetti, Tatiani |4 aut | |
| 700 | 1 | |a Martins, Juliana C. |4 aut | |
| 700 | 1 | |a Rabelo, Lívia F. |4 aut | |
| 700 | 1 | |a Lyon, Ana C. |4 aut | |
| 700 | 1 | |a Martins-Filho, Olindo A. |4 aut | |
| 700 | 1 | |a Johann, Susana |4 aut | |
| 700 | 1 | |a Peres, Nalu T. A. |4 aut | |
| 700 | 1 | |a Coelho dos Reis, Jordana G. A. |4 aut | |
| 700 | 1 | |a Santos, Daniel A. |0 (orcid)0000-0002-1108-5666 |4 aut | |
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