Version 4: Fungal positivity seen in tertiary care hospital during COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) pandemic has been prevailing for more than a year associated with increased number of opportunistic invasive fungal infections in patients who have been critically ill or immunocompromised. In this retrospective study, details of various clinical specimens received from suspected patients of fungal infections were studied. The fungal cultures were seen to be positive in 64% (51/79) COVID-19 positive patients and 43% (163/381) COVID-19 negative patients during the year 2021 in the second wave of COVID-19. Among COVID-19 infected patients, the fungal isolations mostly observed were Candida spp. (63%) followed by Aspergillus spp. (15% ) and Mucor spp. (6%). The maximum samples (17% - COVID-19 positive and 83% - COVID-19 negative patients) which had shown positive results in COVID-19 infected patients were urine followed by serum (for aspergillus galactomannan). The candida isolation was seen in 27% (21/79) urine and 15%(12/79) respiratory samples (BAL, tracheal aspirate, sputum) in COVID-19 positive patients. Rhizopus arrhizus and Rhizopus homothallicus isolations were seen in nasal samples and tissue samples of 6% COVID-19 positive patients. There was an overall increase in fungal co-isolations  during the COVID-19 pandemic (64% in COVID-19 positive and 43% in COVID-19 negative patients) which is a matter of great concern. The correlation of clinical symptomatology and laboratory isolation is important for the diagnosis and effective management of these patients.