PDF(Pubmed)
Abstract：
UNASSIGNED: To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19.
UNASSIGNED: Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed.
UNASSIGNED: The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9-16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113.
UNASSIGNED: COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.
UNASSIGNED: Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed.
UNASSIGNED: The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9-16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113.
UNASSIGNED: COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.
摘要：
■分析COVID-19患者毛霉菌病的潜在诱发因素和临床表现。
■回顾了在比哈尔邦三级护理中心治疗的141例COVID-19相关性毛霉菌病（CAM）患者的病历。诱发因素,临床特征,并对毛霉菌病的影像学表现进行分析。
■年龄中位数为48岁（IQR，43-60).共有58名患者并发CAM和83名CAM后。COVID-19与CAM症状发作之间的中位间隔为15天(IQR，9-16).共有80名患者接受了COVID-19的家庭治疗，其中73名患者患有轻中度疾病。虽然61名患者接受了住院治疗，57人患有严重疾病。在介绍时,131例患者有高血糖症：64例2型糖尿病（DM）和67例新发DM。125例患者存在COVID-19糖皮质激素使用史；47%的患者在家中服用，未监测血糖。常见的表现特征是牙痛，眼周或面部疼痛，和水肿。最常见的是犀眶毛霉菌病。影像学显示所有患者都有鼻-鼻窦炎,包括全鼻窦炎（68%），翼腭窝受累(21%)，海绵窦血栓形成（38%），脑脓肿（8%），和梗死（4%）。所有患者均接受静脉注射两性霉素B脂质体,113例进行了手术清创。
■COVID-19高血糖患者有发展CAM的风险，无论严重程度如何。初级保健医生及时识别症状并迅速开始治疗对于提高预后至关重要。此外,应避免过度使用糖皮质激素，密切监测高血糖的发展是必要的。
■回顾了在比哈尔邦三级护理中心治疗的141例COVID-19相关性毛霉菌病（CAM）患者的病历。诱发因素,临床特征,并对毛霉菌病的影像学表现进行分析。
■年龄中位数为48岁（IQR，43-60).共有58名患者并发CAM和83名CAM后。COVID-19与CAM症状发作之间的中位间隔为15天(IQR，9-16).共有80名患者接受了COVID-19的家庭治疗，其中73名患者患有轻中度疾病。虽然61名患者接受了住院治疗，57人患有严重疾病。在介绍时,131例患者有高血糖症：64例2型糖尿病（DM）和67例新发DM。125例患者存在COVID-19糖皮质激素使用史；47%的患者在家中服用，未监测血糖。常见的表现特征是牙痛，眼周或面部疼痛，和水肿。最常见的是犀眶毛霉菌病。影像学显示所有患者都有鼻-鼻窦炎,包括全鼻窦炎（68%），翼腭窝受累(21%)，海绵窦血栓形成（38%），脑脓肿（8%），和梗死（4%）。所有患者均接受静脉注射两性霉素B脂质体,113例进行了手术清创。
■COVID-19高血糖患者有发展CAM的风险，无论严重程度如何。初级保健医生及时识别症状并迅速开始治疗对于提高预后至关重要。此外,应避免过度使用糖皮质激素，密切监测高血糖的发展是必要的。
