I.V. NIKOLAEVA¹, S.E. MIFTAKHOVA², L.R. GAYNATULLINA², R.KH. ZAKIROV², R.G. NURIEV²

 ¹Kazan State Medical University, Kazan

²Prof. A.F. Agafonov Republic Infectious Clinical Hospital, Kazan

 Contact details:

Nikolaeva I.V. — PhD (Medicine), Professor, Head of the Department of Infectious Diseases

Address: 49 Butlerov St., Kazan, Russian Federation, 420110, tel.: +7-960-037-70-17, e-mail: irinanicolaeva@mail.ru

The purpose is to examine the incidence and clinical characteristics of сandidiasis esophagitis in COVID-19 patients.

Material and methods. We conducted a retrospective observational study by analyzing the medical records of 68 patients with COVID-19 and esophageal candidiasis. All of the patients received in-patient treatment at the Republic Clinical Infectious Diseases Hospital in Kazan from 2020 to 2022.

Results. From 2020 to 2022, 1177 fibrogastroduodenoscopies (FGDS) were performed on patients with COVID-19 at the Republic Clinical Infectious Diseases Hospital in Kazan. Esophageal candidiasis was diagnosed in 68 (5.8%) of the examined patients, Mostly often, elderly patients with chronic pathology of the gastrointestinal tract (65%) and diabetes mellitus (29%). Esophageal candidiasis developed in patients with different severity of COVID-19, including mild forms of infection. According to the Kodsi scale, grade I of esophageal damage was diagnosed in 63.3%, grade II in 27.9%, grade III in 4.4%, grade IV in 4.4% of patients. Patients complained of epigastric pain (34.6%), chest pain (7.7%), dysphagia (7.7%), nausea and vomiting (13.4%), heartburn (1.9%), hiccups (1.9%). 41.5% of patients had no “esophageal” complaints. Antimycotic therapy for candidal esophagitis was carried out with fluconazole at a daily dose of 400 mg, then 200 mg for 14 days. 92.5% of patients were discharged with improvement or clinical recovery. Death occurred in 5 (7.5%) patients. The cause of death was COVID-19 complications (ARDS, PE, multiple organ failure syndrome, acute kidney failure, etc.).

Conclusion. The development of esophageal candidiasis is possible in patients with any severity of COVID-19. Esophageal candidiasis can be asymptomatic. The severity of fungal infection of the esophagus correlates with the severity of coronavirus infection. Patients with severe forms of COVID-19 may develop grades III and IV of esophageal damage. If esophageal candidiasis is detected in a patient with COVID-19, a mycological test of blood, urine and bronchoalveolar lavage should be performed to identify other localizations of invasive candidiasis.

Key words: coronavirus infection, esophageal candidiasis.

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