Severe COVID‐19 patients in ICU are at high risk for candidemia due to exposure to multiple risk factors for candidemia. We aimed to compare the incidence of candidemia in ICU patients with and without COVID‐19, and to investigate epidemiologic and clinical characteristics of candidemia patients and risk factors for mortality in candidemia patients. This retrospective study was conducted in patients followed in the ICUs of Ankara City Hospital for 2 years, divided into pre‐pandemic and pandemic periods. The incidence (event per 1000 patient‐days) and epidemiology of candidemia, clinical and laboratory characteristics of patients were compared in COVID‐19 and non‐COVID‐19 groups. Candidemia incidence was higher in the COVID‐19 group (2.16, 95% CI 1.77–2.60) than the non‐COVID‐19 group (1.06, 95% CI 0.89–0.125) ( p < .001). A total of 236 candidemia episodes (105 in COVID‐19 patients and 131 in non‐COVID‐19 patients) were detected during the study periods. COVID‐19 cases had a higher rate of corticosteroid use (63.8% vs. 9.9%, p < .001). Epidemiology of candidemia and antifungal susceptibility were similar. Candidemia developed 2 weeks earlier in COVID‐19 groups and resulted in higher mortality (92.5% vs. 79.4%, p .005). One‐third of candidemia patients died before receiving any antifungal treatment, and this rate was higher in the COVID‐19 group. In multivariate logistic regression analysis, corticosteroid use, presence of sepsis and age older than 65 years were independent risk factors for mortality in candidemia patients. Candidemia with high mortality is a more serious problem for COVID‐19 patients due to its increased incidence, earlier occurrence and a higher rate of mortality.

Background In this study, we aimed to compare the intensive care unit (ICU) admission rate of hospitalized mild/moderate COVID-19 patients treated with hydroxychloroquine (HCQ), favipiravir, and HCQ plus favipiravir. Methods Single center retrospective designed observational study conducted in Ankara City Hospital. Patients who were hospitalized between March 15, 2020 and June 1, 2020 in COVID-19 inpatient clinics with laboratory confirmed diagnosis of COVID-19 were included in the study. An inverse probability of treatment weighting (IPTW) for multiple treatment groups approach was used to balance the differences in several variables on admission. Results Among 2441 patients hospitalized with diagnosis of COVID-19 during the study period, 824 were eligible for the analysis. Median age of patients was 42 (18-93 years). Among all, 347 (43.2%) of the patients had mild disease, 470 (56.8%) had pneumonia. Propensity scores ranged from 0.1841 to 0.9381 in the HCQ group, from 0.03643 to 0.29885 in the favipiravir group, and from 0.03542 to 0.56184 in the HCQ plus favipiravir group. After IPTW for multiple treatment groups was applied, all the covariates in the planned propensity score had weighted standardized effect sizes below 10% which were ranged from 0.005 to 0.092. Multivariate analysis of treatment effect (adjusted effect of treatment) was indicated that there is no statistically significant difference between HCQ, favipiravir, and HCQ plus favipiravir treatment. After using combination of SMOTE and Bootstrap resampling approach, we found no statistically significant difference between HCQ and HCQ plus favipiravir groups in terms of ICU admission. However, compared with the HCQ group, ICU admission rate was statistically significantly higher in the favipiravir group. We obtained the similar results after the sensitivity analysis. Conclusions HCQ with or without favipiravir treatment is associated with reduced risk of ICU admission compared to favipiravir alone in mild to moderate COVID-19 adult patients.

Introduction There is no published study regarding the effects of preventive measures on coronavirus disease 2019 (COVID-19) frequency in renal transplantation recipients. The aim of this study is to reveal the preventive measures taken by renal transplant recipients during the COVID-19 pandemic and whether these measures influence the prevalence of the disease. Materials and Methods After detecting the first COVID-19 case in Turkey, we briefed all of our renal transplant recipients on preventive measures regarding COVID-19. Two months afterward, a questionnaire was prepared regarding the preventive measures practiced by renal transplant recipients, and patients were asked whether they had any COVID-19 symptoms or had received a COVID-19 diagnosis. Results Among 132 patients, 68 were surveyed through telephone calls. During this time, 95.5% of patients were in isolation at home except for when seeing to their essential needs. Two (2.9%) patients were hospitalized due to increases in creatinine level and urinary tract infection. All patients have worn masks when going out and stated that they washed their hands more frequently. There was a decrease in the frequency of hospital controls in 79.4% of patients. Although 2 (2.9%) patients had complaints of dysuria and fever, they did not apply to the hospital because they thought hospitals carried risk during the pandemic. One patient had a cough with fever and was admitted to the hospital with suspicion of COVID-19 but tested negative. Discussion It was determined that renal transplant recipients in our study population meticulously complied with preventive measures and increased the use of masks and hand hygiene practices. As a result, none were infected with severe acute respiratory syndrome coronavirus 2.

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