Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study
COVID-19-associated invasive fungal infections (CAIFIs) contribute to increased mortality and morbidity rates. This study explores the epidemiology, laboratory parameters, radiological characteristics, treatments, and 30-day mortality risks of CAIFI in critically ill intubated patients while also ev...
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2025-05-01
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| author | Hung Manh Than Thang Van Dao Truong Van Cao Tuyen Van Duong Thach Ngoc Pham Cap Trung Nguyen Phu Dinh Vu Nam Van Le Binh Nhu Do Phuong Viet Nguyen Ha Nhi Vu Duong Minh Vu |
| author_facet | Hung Manh Than Thang Van Dao Truong Van Cao Tuyen Van Duong Thach Ngoc Pham Cap Trung Nguyen Phu Dinh Vu Nam Van Le Binh Nhu Do Phuong Viet Nguyen Ha Nhi Vu Duong Minh Vu |
| author_sort | Hung Manh Than |
| collection | DOAJ |
| description | COVID-19-associated invasive fungal infections (CAIFIs) contribute to increased mortality and morbidity rates. This study explores the epidemiology, laboratory parameters, radiological characteristics, treatments, and 30-day mortality risks of CAIFI in critically ill intubated patients while also evaluating factors associated with prolonged mechanical ventilation (PMV) in this population. Adults admitted to a tertiary hospital from 1 April 2021 to 31 March 2022 who were diagnosed with severe COVID-19, required invasive mechanical ventilation, and developed invasive fungal infection (IFI) during hospitalization were analyzed in this retrospective cohort study. Among 150 patients, 65 (43.3%) required PMV, with an in-hospital mortality rate of 64%. <i>Candida albicans</i> (47%) and <i>Aspergillus fumigatus</i> (27%) were the most prevalent pathogens. Multivariate analysis revealed that COVID-19 vaccination (adjusted odds ratio, aOR = 0.155, 95% confidence interval, 95% CI = 0.029–0.835, <i>p</i> = 0.030) and higher serum protein levels (aOR = 0.900, 95% CI = 0.819–0.989, <i>p</i> = 0.028) were significantly associated with a reduced risk of PMV. Meanwhile, elevated glucose levels (hazard ratio, HR = 1.047, 95% CI = 1.003–1.093, <i>p</i> = 0.036) and an increased neutrophil-to-lymphocyte ratio (HR = 1.024, 95% CI = 1.009–1.039, <i>p</i> = 0.002) were correlated with a greater 30-day mortality risk. Tracheostomy emerged as a protective factor, significantly reducing the risk of 30-day mortality (HR = 0.273, 95% CI = 0.127–0.589, <i>p</i> = 0.001). In this single-center study, patients with CAIFI exhibit a high mortality rate. Clinicians should maintain vigilance for IFI in critically ill COVID-19 patients with mechanical ventilation. |
| format | Article |
| id | doaj-art-9579e68e56d2499fbb3b68390fc91cd2 |
| institution | OA Journals |
| issn | 2414-6366 |
| language | English |
| publishDate | 2025-05-01 |
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| series | Tropical Medicine and Infectious Disease |
| spelling | doaj-art-9579e68e56d2499fbb3b68390fc91cd22025-08-20T01:56:39ZengMDPI AGTropical Medicine and Infectious Disease2414-63662025-05-0110512410.3390/tropicalmed10050124Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational StudyHung Manh Than0Thang Van Dao1Truong Van Cao2Tuyen Van Duong3Thach Ngoc Pham4Cap Trung Nguyen5Phu Dinh Vu6Nam Van Le7Binh Nhu Do8Phuong Viet Nguyen9Ha Nhi Vu10Duong Minh Vu11Emergency Department, National Hospital for Tropical Diseases, Hanoi 11519, VietnamInternational Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanTraining and Direction Center, Institute of Military Preventive Medicine, Hanoi 11519, VietnamInternational Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanDirector Office, National Hospital for Tropical Diseases, Hanoi 11519, VietnamDirector Office, National Hospital for Tropical Diseases, Hanoi 11519, VietnamIntensive Care Unit, National Hospital for Tropical Diseases, Hanoi 11519, VietnamDepartment of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi 12108, VietnamDepartment of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi 12108, VietnamDepartment of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi 12108, VietnamDepartment of Microbiology, Faculty of Basic Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 24117, VietnamIntensive Care Unit, Military Hospital 103, Vietnam Military Medical University, Hanoi 12108, VietnamCOVID-19-associated invasive fungal infections (CAIFIs) contribute to increased mortality and morbidity rates. This study explores the epidemiology, laboratory parameters, radiological characteristics, treatments, and 30-day mortality risks of CAIFI in critically ill intubated patients while also evaluating factors associated with prolonged mechanical ventilation (PMV) in this population. Adults admitted to a tertiary hospital from 1 April 2021 to 31 March 2022 who were diagnosed with severe COVID-19, required invasive mechanical ventilation, and developed invasive fungal infection (IFI) during hospitalization were analyzed in this retrospective cohort study. Among 150 patients, 65 (43.3%) required PMV, with an in-hospital mortality rate of 64%. <i>Candida albicans</i> (47%) and <i>Aspergillus fumigatus</i> (27%) were the most prevalent pathogens. Multivariate analysis revealed that COVID-19 vaccination (adjusted odds ratio, aOR = 0.155, 95% confidence interval, 95% CI = 0.029–0.835, <i>p</i> = 0.030) and higher serum protein levels (aOR = 0.900, 95% CI = 0.819–0.989, <i>p</i> = 0.028) were significantly associated with a reduced risk of PMV. Meanwhile, elevated glucose levels (hazard ratio, HR = 1.047, 95% CI = 1.003–1.093, <i>p</i> = 0.036) and an increased neutrophil-to-lymphocyte ratio (HR = 1.024, 95% CI = 1.009–1.039, <i>p</i> = 0.002) were correlated with a greater 30-day mortality risk. Tracheostomy emerged as a protective factor, significantly reducing the risk of 30-day mortality (HR = 0.273, 95% CI = 0.127–0.589, <i>p</i> = 0.001). In this single-center study, patients with CAIFI exhibit a high mortality rate. Clinicians should maintain vigilance for IFI in critically ill COVID-19 patients with mechanical ventilation.https://www.mdpi.com/2414-6366/10/5/124COVID-19invasive fungal infectionprolonged mechanical ventilationassociated factorsmortality risk |
| spellingShingle | Hung Manh Than Thang Van Dao Truong Van Cao Tuyen Van Duong Thach Ngoc Pham Cap Trung Nguyen Phu Dinh Vu Nam Van Le Binh Nhu Do Phuong Viet Nguyen Ha Nhi Vu Duong Minh Vu Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study Tropical Medicine and Infectious Disease COVID-19 invasive fungal infection prolonged mechanical ventilation associated factors mortality risk |
| title | Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study |
| title_full | Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study |
| title_fullStr | Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study |
| title_full_unstemmed | Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study |
| title_short | Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study |
| title_sort | factors associated with prolonged mechanical ventilation and 30 day mortality in intubated covid 19 patients with invasive fungal infections a retrospective observational study |
| topic | COVID-19 invasive fungal infection prolonged mechanical ventilation associated factors mortality risk |
| url | https://www.mdpi.com/2414-6366/10/5/124 |
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