Prevalence, Molecular Identification, and Genetic Relationships of Oral and Nasal Candidiasis in COVID-19 Patients

Objectives: When COVID-19 emerged as a global pandemic, invasive yeast infections (IYIs) also presented a risk of developing super-infections as another cause of mortality. Our research is to identify the most common Candida species among COVID-19 patients in the Duhok City/Kurdistan region of Iraq. Methods: All confirmed COVID-19 cases were tested by real-time RT-PCR on nasal and oral samples. Culture-based techniques and DNA sequencing of ITS region were used to identify and analyze Candida species. Results: As a result of culture-based techniques, 45 positive Candida isolates were identified out of 100 samples grown on chromogenic Candida agar. The highest percentage belongs to Candida albicans 37.77 %, followed by C. krusei 28.88 %, C. glabrata 20 %, and C. tropicalis 13.33 %. A DNA study revealed new species of Candida africana, C. dublinensis, Kluyveromyces marxianus, Cyberlindnera fabianii, Rhodotorula mucilaginosa, and Purpureocillium lilacinum. Conclusion: To better diagnose, manage, and prescribe the correct antifungal to COVID-19 patients, DNA-based techniques should be used.