■在我们的地区毛霉菌病中心治疗的患者中,研究临床流行病学特征并确定发生COVID-19相关毛霉菌病(CAM)的危险因素。
■这是一项横断面单中心观察性研究。所有入住政府Rajaji医院的CAM患者,2021年4月至2021年8月的马杜赖被纳入研究。有关临床特征的信息,潜在风险因素,诊断检查,收集了合并症。
■共有164例CAM患者入院,平均年龄51.7岁。164名患者中,12例患者无covid阳性,基于成像和RT-PCR,然而,亚临床感染不能排除。在研究的164名患者中,160名患者患有糖尿病,其中66%(n=105)患者有糖尿病史,34%(n=55)新发现糖尿病。大多数患有毛霉菌病的患者患有不受控制的糖尿病(94%),并且没有接受胰岛素治疗。而是单独口服抗糖尿病药物。大多数患者(68%)在COVID-19疾病期间接受了类固醇(静脉/口服)。这些患者中有74%因COVID-19疾病住院。只有30%(n=50)的CAM患者有氧疗史,这些患者中有7%在活动性COVID-19疾病期间在ICU接受治疗。59%的患者在没有足够卫生的情况下使用布口罩,其余41%(n=67)患者重复使用一次性口罩。我们还发现,87%的毛霉菌病患者在COVID-19疾病恢复期接触过有机物质。
■从我们的研究来看,我们发现使用类固醇,糖尿病控制不佳,重复使用面具,每日蒸汽吸入,和暴露于有机物质更与CAM相关,但是氧疗与CAM的相关性较小。因此,我们可以建议在COVID-19后继续筛查高血糖和每日使用一次性手术口罩至少4周.在COVID-19后阶段,类固醇停止后,优选继续滴定剂量的胰岛素和OHA至少4周,因为恢复期的炎性细胞因子水平显著增加。清洁环境卫生也有助于防止CAM。
UNASSIGNED: To
study the clinico-epidemiological profile and identify risk factors for the development of COVID-19-associated mucormycosis (CAM) among the patients treated at our regional mucormycosis center.
UNASSIGNED: This was a cross-sectional single-centre observational
study. All CAM patients admitted to Government Rajaji Hospital, Madurai from April 2021- August 2021 were included in the
study. Information regarding clinical features, potential risk factors, diagnostic workup, and comorbid illness was collected.
UNASSIGNED: A total of 164 patients of CAM were admitted to our hospital with a mean age of 51.7 years. Out of 164 patients, 12 patients were not covid positive, based on imaging and RT-PCR, however subclinical infection could not be ruled out. Out of the 164 patients studied, 160 patients had diabetes, out of which 66% (n = 105) patients had a previous history of diabetes, and 34% (n = 55) had newly detected diabetes. Most of the patients admitted with mucormycosis had uncontrolled diabetes (94%) and were not on insulin therapy, but were on oral antidiabetic drugs alone. The majority of the patients (68%) have received steroids (IV/oral) during the COVID-19 illness. 74% of these patients were under hospitalization for COVID-19 disease. Only 30% (n = 50) of CAM patients had a history of oxygen therapy and 7% of these patients were treated in ICU during active COVID-19 illness. 59% of patients used cloth masks without adequate hygiene, rest 41% (n = 67) patients reused disposable masks. We also found that 87% of the patients developing mucormycosis had exposure to organic material in the convalescence period of COVID-19 illness.
UNASSIGNED: From our
study, we found steroid use, poorly controlled diabetes mellitus, reuse of masks, daily steam inhalation, and exposure to organic matter to be more associated with CAM, but oxygen therapy was less associated with CAM. Hence, we could suggest screening for hyperglycemia and daily use of disposable surgical masks to be continued for at least 4 weeks post-COVID-19. It is preferable to continue insulin in titrated doses along with OHA for at least 4 weeks following steroid cessation in the post-COVID-19 period as there is are considerably increased inflammatory cytokine levels in the convalescence phase. Clean environmental hygiene would also help prevent CAM.