PDF(Pubmed)
Abstract：
Introduction and aim Mucormycosis is a rare but serious angio-invasive infection caused by a group of fungi called mucormycetes and it mainly affects people who are immunocompromised, or patients already infected with other diseases. The dreaded mucormycosis infection has recently gained gross ill-repute for having claimed many lives in coronavirus disease (COVID-19) and/or post-COVID-19 patients. Hence a need was felt to study the development of mucormycosis in COVID-19 patients to better prevent and treat this fungal infection in anticipated future waves of the pandemic. This study also aims to establish an association between COVID-19 positivity, systemic comorbidities, and treatment modalities with the possibility of occurrence of vision and life-threatening mucor infection of the nose, paranasal sinuses, orbit, and brain. Methods This is a hospital-based, retrospective, case-control study. The study reviewed case files of all patients diagnosed with rhino-orbito-cerebral mucormycosis (ROCM) from April 1, 2021, to May 31, 2021. A set of age-matched COVID-19-positive patients hospitalized during the study period with moderate to severe disease were recruited as controls. We addressed factors that could be associated with the development of fungal infection and studied the period between COVID-19 positivity and the onset of ROCM. Results The age of patients in both groups ranged from 40-60 years with 13 females and 17 males. A statistically significant correlation (p-value = 0.032) was found between positive reverse transcription-polymerase chain reaction (RT-PCR) history and use of intravenous (IV) corticosteroids (11 [73.3%] cases and all controls). The mean duration from COVID-19 positivity to the presentation of mucormycosis was 12.10±7.27 days. Uncontrolled blood sugar was found to be the most significant correlation (p-value = 0.003). Mucormycosis is 13.678 times more likely in people with abnormal hemoglobin A1c (HbA1c). Co-morbidities like anemia, chronic kidney disease (CKD), coronary artery disease (CAD), and leukemia were found in controls, but none of these conditions were seen in patients who developed mucormycosis. Conclusion Judicious use of steroids and strict control of blood sugar levels should be emphasized in the management of COVID-19 patients.
摘要：
简介和目的毛霉菌病是一种罕见但严重的血管侵袭性感染，由一组称为粘液菌病的真菌引起，它主要影响免疫功能低下的人。或已经感染其他疾病的患者。可怕的毛霉菌病感染最近因在冠状病毒病(COVID-19)和/或COVID-19后患者中夺走了许多生命而声名狼藉。因此，人们认为有必要研究COVID-19患者的毛霉菌病的发展，以便在预期的未来大流行浪潮中更好地预防和治疗这种真菌感染。这项研究还旨在建立COVID-19阳性之间的关联，系统性合并症，以及可能发生视力和危及生命的鼻子粘液感染的治疗方式，鼻旁窦,轨道,和大脑。方法这是一家以医院为主,回顾性,病例对照研究。该研究回顾了从2021年4月1日至2021年5月31日诊断为犀牛或大脑毛霉菌病（ROCM）的所有患者的病例档案。一组年龄匹配的COVID-19阳性患者在研究期间住院，患有中度至重度疾病，作为对照。我们研究了可能与真菌感染发展相关的因素，并研究了COVID-19阳性和ROCM发作之间的时期。结果两组患者年龄40～60岁,女性13例,男性17例。在逆转录聚合酶链反应（RT-PCR）阳性病史与静脉（IV）皮质类固醇的使用之间发现了统计学上的显着相关性（p值=0.032）（11例[73.3％]病例和所有对照）。从COVID-19阳性到出现毛霉菌病的平均持续时间为12.10±7.27天。未控制的血糖被发现是最显著的相关性(p值=0.003)。在血红蛋白A1c（HbA1c）异常的人群中，毛霉菌病的可能性是13.678倍。贫血等共病,慢性肾脏病（CKD），冠状动脉疾病（CAD），在对照组中发现了白血病，但这些情况均未见于毛霉菌病患者。结论在COVID-19患者的治疗中应重视合理使用类固醇和严格控制血糖水平。
