Study of Covid-19 Associated Fungal Lung Infection and Anti Fungal Susceptibility Pattern With Respect to Candida Species

Introduction: A major healthcare threat emerged in the form of corona virus towards the end of 2019 (COVID-19). Apparently,the novel corona virus (SARS-CoV-2) was capable of spreading and dysregulating the immune mechanisms. The likelihood of developing pulmonary candidiasis wasmore in COVID-19 positive patients,who werehospitalized for long duration of time. Aim: This study aims to report the candidal lung co infection in COVID-19 patients,who were admitted in critical care unit and to rule out the anti fungal susceptibility pattern in respect with Candida species found in those patients. Short term hospital based observational study. Material and Methods: Study Design: Study Population: Patients with positive reports for COVID 19, diagnosed by RT PCR method, admitted in the critical care unit (CCU) of a medical college and hospital. In this short term hospital based observational study Broncho Alveolar Lavage (BAL) samples,of COVID-19 positive patients, who were diagnosed by RT PCR method and admitted to respiratory care unit and followed up in critical care unit of a medical college and hospital, who were suspected as pulmonary candidiasis by chest computed tomography (CT) were collected aseptically followed by ICMR guidelines .Species identication was performed by VITEK-2 automated system and also anti fungal susceptibility testing of Fluconazole, Voriconazole, Amphotericin B, Caspofungin, Micafungin and Flucytosine was performed. Results: Among 350 patients, who were admitted with COVID-19, 18 patients were micro biologically diagnosed as pulmonary candidiasis. The predominant species was Candida albicans followed by Candida glabrata, Candida tropicalis and Candida parapsilosis. In anti fungal susceptibility test 1 isolate displayed multi drug resistance and another4 isolates showed resistant and intermediate pattern of drug sensitivity. Conclusion: This study claries some concern regarding the occurrence of pulmonary candidiasis in COVID-19 patients. As the study was done from microbiological aspect, this study will help to understand the anti fungal drug susceptibility pattern and further management of pulmonary candidiasis in COVID-19 patients. Though further studies should be conducted to design an appropriate prophylaxis programme and improve management of pulmonary candidiasis in critically ill COVID-19 patients.