Risk factors for invasive mold infection after COVID-19: case-control study.

BACKGROUND

Invasive mold infections (IMI) have become common in patients with severe COVID-19 pneumonia, which are difficult to diagnose and treat, with a high mortality rate.

OBJECTIVE

The aim of this study was to determine risk factors for invasive mold infections associated with COVID-19.

METHODS

In this prospective, case-control study, patients treated for severe COVID-19 pneumonia in intensive care units with invasive mold infection were compared with severe COVID-19 pneumonia patients with no secondary infection (bacterial or fungal). Demographics, treatments received and outcomes were compared.

RESULTS

Twenty patients were included in the IMI group and 19 patients in the control group. Invasive aspergillosis was observed in 13 patients (65.0%) while mucormycosis was observed in seven patients (35.0%). Demographics and clinical characteristics were similar between IMI and control group (p>0.005). The 28-day mortality was 60.0% in the IMI group and 15.8% in the control group (p=0.005). The use of steroids has been identified as the most important risk factor for developing IMI (90.0% vs. 15.8%, OR: 25.712, p=0.009).

CONCLUSION

Rationale use of steroids, with appropriate indication, dose and duration is important in the treatment of severe COVID-19 pneumonia.