Abstract：
BACKGROUND: This study aimed to analyze the behavior of acute invasive fungal rhinosinusitis (AIFRS) associated with COVID-19 infection as there has been an increase in the rate of AIFRS cases in the last two years, and many reports connected this rising with the COVID-19 infection. We studied most factors that may impact the prognosis as a trial to find the most affecting factors to improve the outcomes.
METHODS: It was a retrospective observational study that included cases from four tertiary referral institutions between November 2020 to February 2022. We included sixty-six patients who suffered from AIFRS associated with confirmed COVID-19. We observed the prognosis of all included patients with a six-month follow-up. We correlated the prognosis with many factors, such as demographic data, medical conditions, blood investigations, the features of fungal infections, and management.
RESULTS: Forty-two patients (64%) survived after the AIFRS associated with COVID-19, and twenty-two patients (36%) died. High doses of corticosteroids with prolonged use were the main factors that affected the behavior of the AIFRS associated with COVID-19. HbA1c was a good predictor of the prognosis; a level less than 9.35% may indicate survival with 87.5% sensitivity.
CONCLUSIONS: According to this multi-center study, the mortality of the AIFRS associated with COVID-19 was high. The behavior was affected by glycemic control, the type of fungal species, and the type of antifungal therapy. Early surgical debridement, a combination of Amphotericin B with Voriconazole, and anticoagulants helped improve the prognosis.
METHODS: It was a retrospective observational study that included cases from four tertiary referral institutions between November 2020 to February 2022. We included sixty-six patients who suffered from AIFRS associated with confirmed COVID-19. We observed the prognosis of all included patients with a six-month follow-up. We correlated the prognosis with many factors, such as demographic data, medical conditions, blood investigations, the features of fungal infections, and management.
RESULTS: Forty-two patients (64%) survived after the AIFRS associated with COVID-19, and twenty-two patients (36%) died. High doses of corticosteroids with prolonged use were the main factors that affected the behavior of the AIFRS associated with COVID-19. HbA1c was a good predictor of the prognosis; a level less than 9.35% may indicate survival with 87.5% sensitivity.
CONCLUSIONS: According to this multi-center study, the mortality of the AIFRS associated with COVID-19 was high. The behavior was affected by glycemic control, the type of fungal species, and the type of antifungal therapy. Early surgical debridement, a combination of Amphotericin B with Voriconazole, and anticoagulants helped improve the prognosis.
摘要：
背景：这项研究旨在分析与COVID-19感染相关的急性侵袭性真菌性鼻鼻窦炎（AIFRS）的行为，因为过去两年AIFRS病例的发生率有所增加，许多报道将这种上升与COVID-19感染联系起来。我们研究了可能影响预后的大多数因素，作为一项试验，以找到改善预后的最重要因素。
方法：这是一项回顾性观察性研究，包括2020年11月至2022年2月期间来自四个三级转诊机构的病例。我们纳入了66例与确诊COVID-19相关的AIFRS患者。我们观察了所有纳入患者的预后，随访6个月。我们将预后与许多因素相关联，比如人口统计数据，医疗条件,血液调查,真菌感染的特征，和管理。
结果：42例患者(64%)在与COVID-19相关的AIFRS后存活，22例患者(36%)死亡。长时间使用高剂量皮质类固醇是影响与COVID-19相关的AIFRS行为的主要因素。HbA1c是预后的良好预测指标；低于9.35％的水平可能表明生存率为87.5％的敏感性。
结论：根据这项多中心研究，与COVID-19相关的AIFRS死亡率较高。行为受到血糖控制的影响，真菌的种类,以及抗真菌治疗的类型。早期手术清创,两性霉素B与伏立康唑的组合，抗凝剂有助于改善预后。
方法：这是一项回顾性观察性研究，包括2020年11月至2022年2月期间来自四个三级转诊机构的病例。我们纳入了66例与确诊COVID-19相关的AIFRS患者。我们观察了所有纳入患者的预后，随访6个月。我们将预后与许多因素相关联，比如人口统计数据，医疗条件,血液调查,真菌感染的特征，和管理。
结果：42例患者(64%)在与COVID-19相关的AIFRS后存活，22例患者(36%)死亡。长时间使用高剂量皮质类固醇是影响与COVID-19相关的AIFRS行为的主要因素。HbA1c是预后的良好预测指标；低于9.35％的水平可能表明生存率为87.5％的敏感性。
结论：根据这项多中心研究，与COVID-19相关的AIFRS死亡率较高。行为受到血糖控制的影响，真菌的种类,以及抗真菌治疗的类型。早期手术清创,两性霉素B与伏立康唑的组合，抗凝剂有助于改善预后。
