Epidemiology and Infectious DiseasesEpidemiology and Infectious DiseasesЭпидемиология и инфекционные болезни3034-20073034-2015Eco-Vector67807310.17816/EID678073DKCUWHReviewsНаучные обзорыReview ArticleCandidiasis in patients with COVID-19: a reviewКандидозы у пациентов с COVID-19: научный обзорhttps://orcid.org/0000-0002-4897-4547MiftakhovaSofya E.МифтаховаСофья Евгеньевна
Russian Federation

MD

gusevasonya13@gmail.comhttps://orcid.org/0000-0003-0104-58954103-5663NikolaevaIrina V.НиколаеваИрина Венидиктовна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

irinanicolaeva@mail.ruRepublical Clinical Infectious Diseases Hospital named after Professor A.F. AgafonovРеспубликанская клиническая инфекционная больница имени профессора А.Ф. АгафоноваKazan State Medical UniversityКазанский государственный медицинский университет150720252907202530145520304202522052025Copyright ©; 2025, Eco-vectorCopyright ©; 2025, Эко-вектор2025Eco-vectorЭко-векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://rjeid.com/1560-9529/article/view/678073

Coronavirus infection (COVID-19) has led to an increase in the incidence of secondary fungal infections. Patients with COVID-19 have multiple risk factors contributing to their development, including virus-induced immunosuppression, severe lung damage, admission to intensive care units, presence of venous catheters, invasive mechanical ventilation, and treatment with antibiotics, glucocorticoids, and anticytokine agents. Various fungal infections have been diagnosed in patients with COVID-19, including candidiasis, aspergillosis, mucormycosis, and others. However, candidiasis has been the most prevalent mycosis, with its invasive form becoming a serious concern in intensive care unit patients due to its high mortality rate. During the pandemic, in addition to Candida albicans, non-albicans species such as C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei gained clinical significance. The clinical manifestations of candidiasis are nonspecific and are often misinterpreted as symptoms of COVID-19 or signs of secondary bacterial infection. Specific diagnosis of candidiasis involves both culture-based and non-culture-based methods (polymerase chain reaction, detection of (1,3)-β-D-glucan, mannan antigen, and anti-mannan antibodies). The diagnosis of invasive candidiasis is based on the isolation of the pathogen from biopsy samples, tissue aspirates, or normally sterile body fluids (cerebrospinal fluid, blood, etc). Treatment requires a comprehensive approach, including the elimination of possible risk factors, replacement of vascular catheters, and administration of antifungal agents. Resistance of clinical Candida strains to antifungal drugs remains an issue and should be considered when initiating empirical antifungal therapy.

This review summarizes current resources on the prevalence, clinical manifestations, diagnosis, and treatment of candidiasis in patients with COVID-19.

Коронавирусная инфекция (COVID-19) привела к росту заболеваемости вторичными грибковыми инфекциями. Пациенты с COVID-19 имеют множество факторов риска, способствующих их развитию, а именно: вирусную иммуносупрессию, тяжёлое поражение лёгких, нахождение в отделении реанимации и интенсивной терапии, наличие венозных катетеров, инвазивная вентиляция лёгких, терапия антибиотиками, глюкокортикоидами и антицитокиновыми препаратами. У пациентов с COVID-19 диагностированы различные грибковые инфекции: кандидозы, аспергиллёзы, мукормикозы и др. Однако кандидоз являлся самым распространённым микозом, при этом инвазивная его форма стала серьёзной проблемой у пациентов отделения реанимации и интенсивной терапии, ассоциированной с высокой летальностью. В период пандемии наряду с Candida albicans значительную актуальность приобрели не-albicans виды: C. glabrata, C. tropicalis, C. parapsilosis и C. krusei. Клинические проявления кандидозов неспецифичны и их нередко расценивают как симптомы COVID-19 или признаки вторичной бактериальной инфекции. Для специфической диагностики кандидозов используют культуральные и некультуральные методы исследования [полимеразную цепную реакцию, определение (1,3)-β-D-глюкана, антигена маннана и антител к нему]. Диагностика инвазивного кандидоза основана на выделении возбудителя из биоптатов, аспиратов ткани или стерильных в норме жидкостей (спинномозговая жидкость, кровь и т. д.). Его терапия требует комплексного подхода, включающего устранение возможных факторов риска, замену сосудистых катетеров и назначение противогрибковых препаратов. Отмечают проблемы, связанные с резистентностью клинических штаммов кандид к данным препаратам, что следует учитывать при назначении эмпирической противогрибковой терапии.

В настоящем обзоре представлены имеющиеся литературные данные о распространённости, клинических проявлениях, диагностике и лечении кандидоза у пациентов с COVID-19.

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