PDF(Pubmed)
Abstract：
Background Fungal infections, especially mucormycosis, have remarkably surged during the coronavirus disease 2019 (COVID-19) era, especially during the second wave peak of the pandemic raising the concern of the clinicians for the admitted patients. Steroid therapy, diabetes, and other immunocompromised states are more commonly associated with COVID-19-associated mucormycosis (CAM). Aim and objective The aim of this study is to ascertain the prevalence of fungal infections amidst the second wave of the COVID-19 pandemic and discern the associated risk factors. Materials and methods During the second peak of COVID-19, samples were received in the microbiology laboratory from all clinically suspected mucormycosis patients. These samples underwent processing for potassium hydroxide (KOH) wet mount, fungal culture on Sabouraud\'s dextrose agar (SDA) medium, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) testing. All relevant clinical and associated risk factors were tabulated and analyzed. Results Among the 107 suspected cases of mucormycosis, 39 (36.4%) were confirmed positive for COVID-19 via RT-PCR, while 68 (63.6%) tested negative. Males exhibited a predominant infection rate, with the rhinocerebral system being the most commonly affected site. Significantly higher mortality rates were observed in COVID-19-associated mucormycosis (CAM) patients (33.4%) compared to those without COVID-19 (5.9%), with a notable p-value of 0.0005. CAM patients also demonstrated a higher frequency of ICU admissions (77%) compared to non-COVID-19-associated mucormycosis patients (21.4%), a statistically significant finding (p-value of 0.007). Additionally, immunocompromised states, diabetes, and the administration of oxygen therapy were identified as significant risk factors in CAM (p < 0.05). Notably, mucormycosis accounted for the majority of fungal isolates (48.27%) among COVID-19 patients. Conclusion Mucormycosis infection is more commonly seen in COVID-19-infected patients as compared to non-COVID-19 patients, especially with comorbidities such as diabetes mellitus, steroid usage, and other immunocompromised states.
摘要：
背景真菌感染，尤其是毛霉菌病,在2019年冠状病毒病(COVID-19)时代，特别是在大流行的第二波高峰期间，引起了临床医生对入院患者的关注。类固醇治疗,糖尿病,和其他免疫受损状态更常见于COVID-19相关毛霉菌病（CAM）。目的和目的本研究的目的是确定COVID-19大流行第二波中真菌感染的患病率，并辨别相关的危险因素。材料和方法在COVID-19的第二个高峰期间，微生物学实验室接收了所有临床怀疑的毛霉菌病患者的样品。这些样品经过氢氧化钾（KOH）湿法安装处理，在Sabouraud的葡萄糖琼脂（SDA）培养基上进行真菌培养，和COVID-19逆转录聚合酶链反应（RT-PCR）检测。对所有相关的临床和相关的危险因素进行列表和分析。结果107例疑似毛霉菌病病例中,39例（36.4%）通过RT-PCR确认COVID-19呈阳性，而68（63.6%）检测阴性。男性表现出主要的感染率，鼻脑系统是最常受影响的部位。与没有COVID-19的患者（5.9％）相比，COVID-19相关的毛霉菌病（CAM）患者的死亡率显着提高（33.4％），显著的p值为0.0005。与非COVID-19相关毛霉菌病患者(21.4%)相比，CAM患者入住ICU的频率也更高(77%)，具有统计学意义的发现（p值为0.007）。此外,免疫受损状态，糖尿病,和氧疗的给药被确定为CAM的显著危险因素(p<0.05)。值得注意的是,在COVID-19患者中，毛霉菌病占真菌分离株的大多数（48.27%）。结论与非COVID-19患者相比，毛霉菌病在COVID-19感染患者中更常见。尤其是糖尿病等合并症，类固醇的使用,和其他免疫受损状态。
