The study aimed to investigate the causative species, antifungal susceptibility, and factors associated with oropharyngeal candidiasis (OPC) among Egyptian COVID-19 patients. This is an observational, case-controlled, single-center study that included three groups: COVID-19 patients (30), COVID-19 patients with OPC (39), and healthy individuals (31). Patients’ demographic data (age, sex), laboratory tests, comorbidities, treatment, and outcomes were included. Candida species were isolated from COVID-OPC patient’s oropharyngeal swabs by convenient microbiological methods. Isolated strains were tested for antimicrobial susceptibility, biofilm production, aspartyl protease, and phospholipase activities. The most common respiratory symptoms reported were dyspnea (36/39; 92.4%) and cough (33/39; 84.7%). Candida albicans was the most common isolated species, accounting for 74.36% (29/39), followed by Candida tropicalis and Candida glabrata (15.38% and 10.26%, respectively). Amphotericin was effective against all isolates, while fluconazole was effective against 61.5%. A total of 53.8% of the isolates were biofilm producers. The phospholipase activity of C. albicans was detected among 58.6% (17/29) of the isolates. Significant variables from this study were used to create two equations from a regression model that can predict the severity of disease course and liability to fungal infection, with a stativity of 87% and 91%, respectively. According to our findings, COVID-19 patients with moderate to severe infection under prolonged use of broad-spectrum antibiotics and corticosteroids should be considered a high-risk group for developing OPC, and prophylactic measures are recommended to be included in the treatment protocols. In addition, due to the increased rate of fluconazole resistance, other new antifungals should be considered.

Conclusion:HSV1 and HSV2 seroprevalence is prevalent among Egyptian children.

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Background: Oral candidiasis is considered the most common fungal infection in humans. Polyene or azole antifungal drugs can be used for Candida infection. In addition, Nystatin therapy is used in mild forms of oral candidiasis. However, the current literature reports conflicting results regarding azithromycin and hydroxychloroquine for COVID-19. Objective: We aim to evaluate the resistance of oral Candida albicans to fluconazole and nystatin in healthy individuals who have received therapy for suspected COVID-19 with azithromycin and hydroxychloroquine. Methodology: The current case-control study collected samples of oral candidiasis from two types of patients. The cases group (group 1) were patients with confirmed COVID-19; the control group (group 2) were healthy controls without previous COVID-19. The antifungal susceptibility was examined based on the principles of M44-A suggested by the Clinical and Laboratory Standards Institute (CLSI). Results: Thirty patients were included in the cases group. In terms of the antifungal susceptibility between the study groups, the study showed the details of fluconazole and nystatin resistance. Fluconazole resistance was detected significantly higher in 86.7% of the cases group compared with only 56.7% of the subjects in the control group (P=0.010). Similarly, nystatin resistance was significantly higher in 76.7% of the cases group, while the control group showed 23.3% drug resistance (P< 0.001). Conclusion: Treating COVID-19 patients with hydroxychloroquine and azithromycin negatively impacted the antimicrobial resistance (AMR) of oral candidiasis. Given the limited efficacy of both treatments, avoiding the broad-spectrum use of both agents in managing COVID-19 patients is advisable.

Major depressive disorder (MDD) is one of the most prevalent psychiatric and immune system illnesses worldwide. Recent studies have found a possible relationship between MDD and immune dysregulation, which manifests as an alteration in inflammatory biomarkers. Objectives: We aim to investigate the role of CD4, CD8, and CD137 expressions on T cells among patients suffering from major depressive disorder (MDD) not under treatment in comparison with normal individuals. Methodology: The current study was comparative and descriptive conducted on middleaged patients (age range 18-60 years old) who were diagnosed with MDD. Assessing the differences in T cell expression of CD 4, CD 8, and CD 137 molecules between MDD cases and healthy controls was the primary outcome of our study. Results: In this study, we included 50 patients with MDD and a similar number of healthy controls. In terms of the primary outcomes of the present study. The study results found statistically significant differences between cases and controls in terms of CD4 (P=0.001), CD8 (P=0.001), and CD137 expression (P=0.001). MMD patients had significantly lower expression of CD4 (582.88 ± 133.13 versus 775.04±159.6 in the control group), CD8 (374.24 ±204.8 versus 524.04 ± 195.3 in the control group), and CD137 (391.04 ±158.2 versus 587.52±191.7 in the control group). Conclusion: We can state that there is a strong association between immune status and patients with MDD, especially naïve patients. This was confirmed according to the significant decrease in the CD4, CD8, and CD137 levels.