Introduction: Candida auris has been reported as emerging yeast pathogen that can cause invasive bloodstream infections in healthcare settings, especially in ICU. 

Aim: To investigate the prevalence of C.auris among tobacco smokers regarding APACHE score, imaging, and inflammatory biomarkers.  

 Material: We conducted a retrospective review of epidemiological, clinical, and microbiological records at a referral COVID 19 ICU between 08/2021-3/2022. Demographic data, tobacco use and addiction, comorbidities, microbiology investigation, emphysema score by chest CT, treatment regimens and outcomes were determined. 

 Results: 40 patients (24 men), mean age 73.6 years with median ICU length of stay 42.5 days and 51.7% mortality. Current smokers 35±4 pack/yrs (11 men/7 women), ex-smokers (8 men/6 women) with Fagerström Test 6±2. Main comorbidities were diabetes (55%), CVD (48%), hypertension (61%), COPD (35%), ???>30 (34%), neoplasia (17%). Higher APACHE ?? score was measured in current smokers (48±8) with higher Fagerström Test (p=0.001) and ex-smokers (39±6) (p=0.003). Current smokers and ex-smokers were hospitalized in ICU for a longer period 29±7 days (p=0.001). 31% current and ex-smokers patients with higher addiction presented CT findings of pulmonary emphysema with emphysema score (16/11 respectively) (p=0.001).

 Conclusion: Tobacco smoking is a serious comorbidity in COVID 19 ICU patients infected with C.auris with both current smokers and ex-smokers reveal more severe rates of mortality and morbidity