Diabetes and Candidemia in COVID-19 Pandemic
Goknur Yorulmaz *, Ruya Mutluay, Pinar Yildiz, Huseyin Yildirim, and Yasemin Oz
Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
Candida species can become pathogenic under certain conditions and cause diseases ranging from common superficial infections to severe systemic infections. Intensive care unit (ICU) patients are particularly susceptible to invasive Candida infections. In our study, we evaluated the frequency of diabetes mellitus in internal ICU patients with candidemia. We divided the patients into the COVID-19 period (3 years) and the pre-COVID-19 period (3 years before the COVID-19 pandemic). A total of 383 patients had bloodstream infections caused by Candida spp. during the six-year study period; 73.6% of these constituted patients with diabetes mellitus and 82.2% of the patients died. While 86% of the patients who died during the pre-COVID-19 period were diabetic, only 42% of those who died COVID-19 period were diabetic patients. Although there were 302 patients with candidemia in the pre-COVID-19 period, candidemia was detected in only 81 patients during the COVID-19 period. This situation was associated with a decrease in the number of patients due to COVID-19 restrictions. The most common species was Candida albicans (42.5%) in the pre-COVID-19 period and C. parapsilosis, (46%) during the COVID-19 period.
In conclusion, we can think that diabetes predisposes to the development of invasive candida infection. In addition, there was a decrease in the number of blood cultures of intensive care patients due to the restrictions during COVID-19, and it resulted in an increase in the frequency of non-albicans Candida species.