mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2026-17-3-72-85mvjr-2202Research ArticleИНФЕКЦИОННЫЕ БОЛЕЗНИINFECTIOUS DISEASESВлияние грибковых инфекций на течение COVID-19: проспективное обсервационное исследованиеThe impact of fungal infections on the course of disease in patients with COVID-19: a prospective observational studyhttps://orcid.org/0000-0002-4979-8768АвдееваМ. Г.AvdeevaM. G.

Авдеева Марина Геннадьевна, д. м. н., заведующая кафедрой инфекционных болезней и фтизиопульмонологии

Краснодар

Marina G. Avdeeva, Dr. Sci. (Med.), Professor of department of infectious diseases and a ftiziopulmonologiya

Krasnodar

avdeevam@mail.ruhttps://orcid.org/0000-0003-1817-6664КулбужеваМ. И.KulbuzhevaM. I.

Кулбужева Макка Ибрагимовна, к. м. н., доц., доценткафедры инфекционных болезней и фтизиопульмонологии

Краснодар

Makka I. Kulbuzheva, Cand. Sci. (Med.), Associate Professor of department of infectious diseases and a ftiziopulmonologiya

Krasnodar

kulbuzhevamakka@yandex.ruhttps://orcid.org/0000-0001-7417-8897ИльинО. И.IlyinO. I.

Ильин Олег Игоревич, ассистент кафедры инфекционных болезней и фтизиопульмонологии

Краснодар

Oleg I. Ilyin, Assistant Lecturer of the Department of Infectious Diseases and Phthisiopulmonology

Krasnodar

ilinolegg@gmail.comКубанский государственный медицинский университетРоссияKuban State Medical UniversityRussian FederationКубанский государственный медицинский университет; Специализированная клиническая инфекционная больницаРоссияKuban State Medical University; Specialized Clinical Infectious Diseases HospitalRussian Federation2026220920261737285Copyright © Авдеева М.Г., Кулбужева М.И., Ильин О.И., 20262026Авдеева М.Г., Кулбужева М.И., Ильин О.И.Avdeeva M.G., Kulbuzheva M.I., Ilyin O.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/2202

Цель: анализ проявлений грибковых осложнений при COVID-19 и их влияния на характер течения и исход заболевания с учётом коморбидной патологии. Материалы и методы: исследованы виды грибковых осложнений у 118 взрослых госпитализированных пациентов с COVID-19. Группы сравнения составили 23 умерших с грибковыми осложнениями, 35 умерших без грибковых осложнений, 35 выздоровевших пациентов, имевших грибковые осложнения, и 25 выздоровевших без грибковых осложнений. Результаты: установлено, что присоединение грибковой флоры утяжеляет течение COVID-19 и является ассоциированным с неблагоприятным прогнозом. Ключевое значение имеют сроки диагностики и локус выделения возбудителя: определение грибковой инфекции на третьей неделе и позже достоверно связано с летальным исходом. Неблагоприятным прогностическим признаком является кандидемия (выделение грибов из мокроты), что требует инструментального контроля и назначения противогрибковой терапии. Факторами риска развития грибковых осложнений является возраст старше 60 лет, наличие хронической патологии сердечно-сосудистой, дыхательной систем, гипотиреоза, онкологических заболеваний, ВИЧ-инфекции. Спектр грибковых возбудителей представлен преимущественно Candida albicans (96,6%). Прогностическим маркером неблагоприятного исхода является сочетание грибковой и бактериальной инфекциий, особенно при выделении P. aeruginosa, MDR Acinetobacter, K. pneumoniae и A. baumannii. Заключение: полученные данные обосновывают необходимость раннего микологического мониторинга у пациентов с COVID-19, особенно при наличии факторов риска, с целью своевременного выявления грибковых осложнений и назначения адекватной терапии, что может существенно улучшить прогноз заболевания.

Objective: to analyze the manifestations of fungal complications in COVID-19 and their impact on the course and outcome of the disease, taking into account comorbid pathology. Materials and methods: the types of fungal complications were studied in 118 adult hospitalized patients with COVID-19. The comparison groups consisted of 23 patients who died with fungal complications, 35 patients who died without fungal complications, 35 patients who recovered with fungal complications, and 25 patients who recovered without fungal complications. Results: it was established that the presence of fungal flora worsens the course of COVID-19 and is associated with an unfavorable prognosis. The timing of diagnosis and the location of the pathogen isolation are key: the detection of a fungal infection in the third week and later is significantly associated with a fatal outcome. Candidemia (the isolation of fungi from sputum) is an unfavorable prognostic sign, requiring instrumental monitoring and the prescription of antifungal therapy. Risk factors for developing fungal complications include age over 60, chronic cardiovascular and respiratory diseases, hypothyroidism, cancer, and HIV infection. Fungal pathogens are predominantly Candida albicans (96.6%). A combination of fungal and bacterial infections, particularly P. aeruginosa, MDR Acinetobacter, K. pneumoniae, and A. baumannii, is a prognostic marker for an adverse outcome. Conclusion: the data obtained support the need for early mycological monitoring in patients with COVID-19, especially those with risk factors, to promptly identify fungal complications and initiate appropriate therapy, which can significantly improve the prognosis.

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The authors declare that there are no conflicts of interest present.