COVID-19–associated invasive fungal infections in intensive care unit patients during the first pandemic waves in Argentina: Results of a single center experience

POSSE, GLADYS BEATRIZ; BARBERIS, FERNANDA MARIEL; BENEDETTI, MARÍA FERNANDA; PEZZOLA, DANIEL; HERMIDA ALAVA, KATHERINE; RODRÍGUEZ LABOCCETTA, CAROLINA; VIDELA GARRIDO, AGUSTÍN; FERNÁNDEZ BRICEÑO, VÍCTOR; CAPECE, PAULA; NUSBLAT, ALEJANDRO; CUESTAS, MARÍA LUJÁN

MEDICAL MYCOLOGY

TAYLOR & FRANCIS LTD

Año: 2025 vol. 63

1369-3786

Critically ill COVID-19 patients are at high risk for invasive fungal infections (IFIs). Data on IFI prevalence in severe COVID-19 patients in LatinAmerica are scarce. This study aimed at analyzing the prevalence and outcomes of IFIs in COVID-19 patients from Argentina. For this purpose,a retrospective study was conducted on COVID-19 patients admitted to the intensive care unit of a hospital in Buenos Aires between 2020 and2022, with mycological evidence of IFI. A total of 86 cases of IFIs were reported, including 50 cases of COVID-19–associated candidiasis (CAC),29 of COVID-19–associated pulmonary aspergillosis (CAPA), 10 of COVID-19–associated histoplasmosis (CAH), two cases of cryptococcemia,and one case of invasive fusariosis. Mixed fungal infections were also detected: two cases of Pneumocystis jirovecii pneumonia with CAPA,two cases of CAC with CAPA, one case of cryptococcemia with CAPA, one case of CAPA with CAH, and one case of CAC with CAPA andCAH. The overall mortality was 67.4%, with mortality of 59.6%, 72.7%, and 62.5% for CAC, CAPA, and CAH, respectively. All cases withmixed fungal infections were fatal. The most frequent underlying comorbidities were arterial hypertension, type-2 diabetes mellitus, obesity,smoking, oncohematological disease, chronic kidney disease, and chronic obstructive pulmonary disease. Candida parapsilosis, C. albicans, andC. tropicalis were the most common species in CAC. Aspergillus fumigatus, A. flavus, A. terreus, and A. niger were predominant in CAPA. Inconclusion, this study highlights the high prevalence and mortality of CAC, CAPA, and CAH in severe COVID-19 patients from Argentina.