{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:47:16Z","timestamp":1792572436714,"version":"4.5.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The occurrence of oral candidiasis (OC) is expected in patients with COVID-19, especially those with moderate to severe forms of infection who are hospitalized and may be on long-term use of broad-spectrum antibiotics or prolonged corticosteroid therapy. We aimed to characterize clinical conditions, the prevalence profile of <jats:italic>Candida<\/jats:italic> species, and outcomes of COVID-19 patients with OC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this observational study, oral samples were obtained from COVID-19 patients suspected of OC admitted to Razi teaching hospital. Patients with OC were monitored daily until discharge from the hospital. Species identification was performed by a two-step multiplex assay named YEAST PLEX, which identifies 17 clinically important uncommon to common yeast strains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 4133 patients admitted with COVID-19, 120 (2.90%) suffered from OC. The onset of signs and symptoms of OC in patients was, on average (2.92 \u00b1 3.596 days) with a range (of 1-29 days). The most common OC presentation was white or yellow macules on the buccal surface or the tongue. In (39.16%) of patients suffering from OC multiple <jats:italic>Candida<\/jats:italic> strains (with two or more <jats:italic>Candida<\/jats:italic> spp.) were identified. The most common <jats:italic>Candida<\/jats:italic> species were <jats:italic>C. albicans<\/jats:italic> (60.57%), followed by <jats:italic>C. glabrata<\/jats:italic> (17.14%), <jats:italic>C. tropicalis<\/jats:italic> (11.42%), <jats:italic>C. kefyr<\/jats:italic> (10.83%) and <jats:italic>C. krusei<\/jats:italic> (3.42%). Notably, OC caused by multiple <jats:italic>Candida<\/jats:italic> strains was more predominant in patients under corticosteroid therapy (P &amp;lt;0.0001), broad-spectrum antibiotics therapy (P = 0.028), and those who used nasal corticosteroid spray (P &amp;lt;0.0001). The majority of patients who recovered from OC at the time of discharge were patients with OC by single <jats:italic>Candida<\/jats:italic> species (P = 0.049).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Use of corticosteroids and antimicrobial therapy in COVID-19 patients increases risk of OC by multiple <jats:italic>Candida<\/jats:italic> strains.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2022.1103226","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T05:03:30Z","timestamp":1671771810000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Multiple Candida strains causing oral infection in COVID-19 patients under corticosteroids and antibiotic therapy: An observational study"],"prefix":"10.3389","volume":"12","author":[{"given":"Farhang","family":"Babamahmoodi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Sadegh","family":"Rezai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Ahangarkani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Mohammadi Kali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Alizadeh-Navaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Alishahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narges","family":"Najafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azam","family":"Haddadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Davoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Azargon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Daftarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirafkan","family":"Kordi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiana","family":"Abbasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24370","article-title":"Multiplex size marker (YEAST PLEX) for rapid and accurate identification of pathogenic yeasts","volume":"36","author":"Aboutalebian","year":"2022","journal-title":"J. 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