%0 Journal Article
%T Invasive fungal rhinosinusitis associated with COVID-19: Course changes and prognosis predictors.
%A Barbara M
%A Elzayat S
%A Lotfy A
%A Sabino L
%A Bandiera G
%A Elsherif HS
%A Youssef M
%A Fouad A
%A Nasr K
%A Volpini L
%A Elfarargy HH
%J Acta Otorrinolaringol Esp (Engl Ed)
%V 74
%N 4
%D Jul-Aug 2023 29
%M 36460059
暂无%R 10.1016/j.otoeng.2022.11.010
%X 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.