# Correlation between the severity of COVID-19 infection and the presence of oropharyngeal candidiasis: a cross-sectional study in Al-Diwaniyah Hospital, Iraq

## TL;DR

This study found that severe COVID-19 patients are more likely to have oral thrush, a fungal infection, and showed higher inflammation levels.

## Contribution

The study identifies a significant correlation between severe COVID-19 and oropharyngeal candidiasis in a specific patient population.

## Key findings

- 45% of severe COVID-19 patients had oropharyngeal candidiasis compared to 15% with mild and 25% with moderate symptoms.
- Patients with candidiasis had significantly higher CRP levels (12.5 mg/l) than those without (6.8 mg/l).
- Longer hospital stays and corticosteroid use were associated with higher candidiasis prevalence.

## Abstract

oropharyngeal candidiasis, commonly known as oral thrush, is a fungal infection caused by candida species, especially Candida albicans. With the onset of COVID-19, concerns have arisen about a possible link between the severity of COVID-19 infections and the presence of oropharyngeal candidiasis in patients. The aim to study the frequency of oropharyngeal candidiasis in COVID-19 patients and identify associated risk factors.

a cross-sectional study involving 100 COVID-19 patients was conducted at Al-Diwaniyah Hospital in Iraq. Samples were collected using blood tests and oropharyngeal tampons to diagnose oropharyngeal candidiasis. The mean age of the study population was 55.3 years (SD±12.4), with 60% male and 40% female. The data was analyzed using IBM SPSS software version 22, focusing on the correlation between the severity of COVID-19 and the occurrence of candidiasis.

among the 100 patients, 30 (30%) were diagnosed with oropharyngeal candidiasis. In patients with severe COVID-19 (45%) symptoms, the prevalence was significantly higher than in patients with mild (15%) and moderate (25%) symptoms (p=0.002). In addition, patients with candidiasis (CRP: 12.5 mg/l) had significantly higher mean levels of C-reactive protein (CRP: 12.5 mg/l) than patients without candidiasis (CRP: 6.8 mg/l, p < 0.001). Other risk factors identified included long-term hospitalization (mean duration of patients with candidiasis 12 days vs. 7 days without patients, p=0.005) and use of corticosteroids (70% of patients with candidiasis vs. 40% without, p=0.01).

the results show that oropharyngeal candidiasis is common among COVID-19 patients, especially those with severe infections, with a prevalence rate of 45%. The study emphasizes the importance of monitoring fungal infections in COVID-19 patients and the need for early diagnosis and treatment to improve patient outcomes. These findings are supported by the significant differences in prevalence and inflammatory markers observed in the study.