Volume 29, Number 7—July 2023
Dispatch
Increased Hospitalizations Involving Fungal Infections during COVID-19 Pandemic, United States, January 2020–December 2021
, Stacey Adjei, Adi V. Gundlapalli, Ya-Lin A. Huang, Tom Chiller, Kaitlin Benedict, and Mitsuru Toda
Table 1
Hospitalization rates for invasive fungal infections associated with COVID-19 in study of increased hospitalizations involving fungal infections during COVID-19 pandemic, United States, January 2020–December 2021*
| Fungal pathogen | All fungal hospitalizations, n = 59,212 |
COVID-19–associated hospitalizations,† n = 5,288 |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| 2019 | 2020 | 2021 | p value‡ | % Change§ | 2020 | 2021 | p value‡ | % Change¶ | |
| Pathogenic fungi | 22.3 | 25.0 | 26.8 | <0.01 | 8.5 | 43.1 | 57.4 | <0.01 | 24.9 |
| Candida | 4.2 | 5.3 | 5.6 | <0.01 | 12.4 | 11.2 | 10.9 | 0.69 | −2.4 |
| Aspergillus | 4.3 | 4.2 | 5.3 | <0.01 | 9.4 | 7.9 | 18.9 | <0.01 | 58.2 |
| Coccidioides | 3.2 | 4.0 | 4.3 | <0.01 | 13.0 | 6.6 | 7.4 | 0.15 | 10.4 |
| Pneumocystis | 2.6 | 2.4 | 2.5 | 0.08 | −2.7 | 1.9 | 2.6 | 0.03 | 25.4 |
| Histoplasma | 1.4 | 1.6 | 1.6 | <0.01 | 5.6 | 1.1 | 1.6 | 0.03 | 32.1 |
| Cryptococcus | 1.3 | 1.4 | 1.2 | 0.46 | −2.0 | 1.2 | 1.4 | 0.48 | 11.6 |
| Blastomyces | 0.3 | 0.3 | 0.4 | <0.01 | 11.7 | 0.2 | 0.5 | <0.01 | 65.6 |
| Mucorales species | 0.3 | 0.3 | 0.4 | <0.01 | 17.9 | 0.7 | 1.1 | 0.02 | 39.8 |
| Other specified fungi | 1.5 | 1.6 | 1.5 | 0.38 | −1.9 | 1.7 | 2.5 | <0.01 | 32.9 |
| Unspecified | 4.0 | 4.9 | 5.1 | <0.01 | 10.8 | 12.2 | 12.7 | 0.47 | 4.1 |
*Rates are per 10,000 hospitalizations. The total number of hospitalizations per year was 8,884,472 in 2019, 7,640,470 in 2020 (424,475 COVID-19–associated), and 7,559,882 in 2021 (601,831 COVID-19–associated). Patients could have >1 fungal infection in a given hospitalization, which occurred for <5% of hospitalizations. †Hospitalizations of patients with COVID-19–associated fungal infections. ‡Calculated by using Cochran-Armitage tests. §Average annual percentage change during 2019–2021. ¶Annual percentage change during 2020–2021.