■在2019年冠状病毒病(COVID-19)患者中越来越多地描述了毛霉菌病(MCR),但是流行病学因素,神经表现,和这些患者的结果没有很好的描述。
■为了研究患者的人口统计学,出现症状和体征,合并症的作用,用于治疗COVID-19的药物以及治疗结果,并研究神经轴受累的范围及其结果。
■这是一个前景,观察,横断面医院单中心队列研究。收集有和没有COVID-19的确认MCR病例。该研究从2021年5月至7月进行了3个月,随后进行了3个月的随访。关于流行病学因素的信息,神经系统的发现,治疗(包括内科和外科治疗),并记录结果。
■总共141名患者被诊断为MCR,其中98例为COVID相关MCR(CAM)。COVID-19阳性患者的CAM发生率为0.39%。90天的MCR病死率为43.9%,但CAM患者的病死率高于非CAM患者。年龄较大(>50岁),糖尿病,多种危险因素,入院时糖尿病酮症酸中毒,大脑参与,COVID-19肺炎病史与较高的死亡风险相关。
■可能是因为皮质类固醇使用不当,锌,氧气,还有托珠单抗,在COVID-19大流行中,MCR病例突然激增。因此,治疗医生应谨慎使用COVID-19肺炎方案。神经系统受累本身是一个不良的预后信号,但手术和医疗联合治疗效果更好.
UNASSIGNED: Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19), but the epidemiological factors, neurological presentation, and outcome of such patients are not well described.
UNASSIGNED: To
study the patient demographics, presenting symptoms and signs, the role of co-morbidities, medications used to treat COVID-19, and the outcomes of management and to
study the spectrum of neuraxis involvement and its outcome.
UNASSIGNED: It was a prospective, observational, cross-sectional hospital-based single center cohort
study. Confirmed MCR cases with and without COVID-19 were collected. The
study was carried out over a period of 3 months from May to July 2021, followed by 3-month follow-up. Information on epidemiological factors, neurological findings, treatment (including medical and surgical treatment), and outcome was recorded.
UNASSIGNED: A total of 141 patients were diagnosed with MCR, out of which 98 were COVID-associated MCR (CAM). The CAM incidence was 0.39% among COVID-19-positive patients. The MCR case fatality rate at 90 days was 43.9% but was higher for CAM than for non-CAM patients. Older ages (>50 years), diabetes mellitus, multiple risk factors, diabetic ketoacidosis on admission, brain involvement, and history of COVID-19 pneumonitis were associated with a higher risk for death.
UNASSIGNED: Possibly because of improper usage of corticosteroids, zinc, oxygen, and tocilizumab, there was sudden surge of cases of MCR in the COVID-19 pandemic. Therefore, treating physicians should use the COVID-19 pneumonia regimen judiciously. Neurological involvement itself is a poor prognostic sign, but combined surgical and medical management exhibited better outcome.