THE COVID-19 pandemic saw an increase of more than 8% in hospitalisations due to fungal infections in the USA, compared to previous years. Additionally, the mortality rates due to COVID-19-related fungal infections were approximately four times higher than in infections that were not related to COVID-19.
Comprehensive data on the outcomes associated with fungal infections in patients with COVID-19 are lacking, which is why Jeremy Gold, Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), and colleagues, conducted a study to estimate the hospitalisation rates by fungal infection types from 2019–2021, calculating the average annual percentage. Hospitalisation rates per 10,000 COVID-19 hospitalisations were calculated and stratified by fungal infection type and COVID-19 association. Other data, including patient demographics, intensive care unit admissions, and length of hospital stays were also compared.
The team noted an increase in fungal hospitalisations from 22.3 in 2019 to 25.0 in 2020 and 26.8 in 2021, or an annual percentage change of 8.5%. In total, 13.4% of fungal hospitalisations were related to COVID-19, and the rate of COVID-19-related fungal hospitalisations increased from 43.1% to 57.4%, with blastomycosis, aspergillosis, and mucormycosis infections increasing the most. These hospitalisations led to longer hospital stays (21 days versus 9 days), receipt of invasive mechanical ventilation (64.4% versus 22.5%), intensive care unit-level care (70.0% versus 35.5%), and increased in-hospital deaths (48.5% versus 12.3%) compared to non-COVID-19 associated fungal infections. Aspergillosis, invasive candidiasis, mucomyrcosis, and unspecified mycoses were associated with the highest mortality. The team further noted that Hispanic/Latino males were more frequently affected by COVID-19-associated fungal infections compared to infections that were not related to COVID-19.
“We hope that our study will promote increased awareness about fungal diseases among clinicians, particularly in people with COVID-19, as earlier testing and treatment for fungal infections can save lives,” stated Gold. They highlighted the racial and ethnic disparities observed among these patients, which are increased by underlying conditions (e.g., diabetes) increasing the risk for fungal diseases.
