PDF(Pubmed)
Abstract：
In India, the incidence of mucormycosis reached high levels during 2021-2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March-July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease\'s clinical progression and help frame standard treatment guidelines.
摘要：
在印度,在2021-2022年期间，毛霉菌病的发病率达到较高水平，与COVID-19大流行相吻合。对此,我们建立了印度各地毛霉菌病住院患者的多中心综合队列.在本文中,我们报告了他们的基线资料，临床特征和出院时的结局。包括2021年3月至7月期间因毛霉菌病住院的患者。毛霉菌病是根据直接显微镜（KOH/Calcofluor白色染色）的真菌学确认诊断的，文化,组织病理学,或内窥镜检查或成像的支持性证据。同意后,训练有素的数据收集者使用医疗记录和电话访谈来捕获预先测试的结构化问卷中的数据。在基线,我们从26家研究医院招募了686名患者，其中72.3%是男性，78%有糖尿病史,53.2%有皮质类固醇治疗史,80%与COVID-19相关。疼痛,面部麻木或肿胀是最常见的症状(73.3%)。脂质体两性霉素B是最常用的药物制剂（67.1％），内窥镜鼻窦手术是最常见的手术方式(73.6%)。出院时,病情稳定在43.3%,消退29.9%，但9.6%在住院期间死亡。在幸存者中，通常报告的残疾包括面部毁容(18.4%)和咀嚼/吞咽困难(17.8%)。尽管死亡的风险只有十分之一，但由于疾病而导致的残疾非常高。这项队列研究可以增强我们对疾病临床进展的理解，并有助于制定标准治疗指南。
