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Abstract Background Critically ill COVID-19 patients are highly susceptible to opportunistic fungal infection due to many factors, including virus-induced immune dysregulation, host-related comorbidities, overuse and misuse of antibiotics or corticosteroids, immune modulator drugs, and the emergencies caused by the pandemic. This study aimed to assess the incidence, identify the potential risk factors, and examine the impact of fungal coinfection on the outcomes of COVID-19 patients admitted to the intensive care unit (ICU). Methods A prospective cohort study including 253 critically ill COVID-19 patients aged 18 years or older admitted to the isolation ICU of Zagazig University Hospitals over a 4-month period from May 2021 to August 2021 was conducted. The detection of a fungal infection was carried out. Results Eighty-three (83) patients (32.8%) were diagnosed with a fungal coinfection. Candida was the most frequently isolated fungus in 61 (24.1%) of 253 critically ill COVID-19 patients, followed by molds, which included Aspergillus 11 (4.3%) and mucormycosis in five patients (1.97%), and six patients (2.4%) diagnosed with other rare fungi. Poor diabetic control, prolonged or high-dose steroids, and multiple comorbidities were all possible risk factors for fungal coinfection [OR (95% CI) = 10.21 (3.43–30.39), 14.1 (5.67–35.10), 14.57 (5.83–33.78), and 4.57 (1.83–14.88), respectively]. Conclusion Fungal coinfection is a common complication of critically ill COVID-19 patients admitted to the ICU. Candidiasis, aspergillosis, and mucormycosis are the most common COVID-19-associated fungal infections and have a great impact on mortality rates.

Background: The CDC recommended conducting insistent surveillance for catheter-associated urinary tract infection (CAUTI) helping in the early identification of patients based on the frequency of catheter use and potential risk. One of the largest problems facing public health is the COVID-19 pandemic. Aim: This study aimed to highlight the frequency of CAUTI, and antibiotic susceptibility profile of isolated bacteria recovered from COVID-19 patients and to compare resistance patterns with CAUTI cases during the pre-COVID period. Study design: This study included prospective and retrospective parts and included two ICUs at Zagazig University Hospitals that was transformed into an isolation hospital during Coronavirus disease 2019 pandemic. Methods: Patients included were clinically suspected of having catheter-associated urinary tract infection during two different stages; the pre-COVID period and the COVID-19 second wave. Results: This study was conducted on 479 catheterized hospitalized patients at Zagazig University ICUs (362 inpatients hospitalized pre–COVID-19 period, and 117 inpatients hospitalized during the second COVID-19 wave). The CAUTI rate during the COVID-19 second wave was statistically higher significant than the CAUTI rate during the per-COVID-19 period. Conclusion: The current study demonstrated an increased frequency of CAUTI among catheterized ICU patients during the second COVID-19 pandemic wave. The rates of carbapenem-resistant Enterobacteriaceae, MDR A. baumannii, and ESBL- Pseudomonas aeruginosa were significantly increased. These findings may indicate the increased risk of CAUTI and increased prevalence of isolated MDRO during the COVID-19 second wave.