Esma Eryilmaz-Eren, Hafize Sav, Zuhal Ozer-Simsek, İbrahim Ozcan, Aysin Kilinc-Toker, Azade Kanat, Ali Cetinkaya, Recep Civan Yuksel, Kaniye Aydin, Seda Guzeldag, Ilhami Celik
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Abstract
Background: Invasive mold infections (IMI) have become common in patients with severe COVID-19 pneumonia, which are difficult to diagnose and treat, with a high mortality rate.
Objective: The aim of this study was to determine risk factors for invasive mold infections associated with COVID-19.
Methods: In this prospective, case-control study, patients treated for severe COVID-19 pneumonia in intensive care units with invasive mold infection were compared with severe COVID-19 pneumonia patients with no secondary infection (bacterial or fungal). Demographics, treatments received and outcomes were compared.
Results: Twenty patients were included in the IMI group and 19 patients in the control group. Invasive aspergillosis was observed in 13 patients (65.0%) while mucormycosis was observed in seven patients (35.0%). Demographics and clinical characteristics were similar between IMI and control group (p>0.005). The 28-day mortality was 60.0% in the IMI group and 15.8% in the control group (p=0.005). The use of steroids has been identified as the most important risk factor for developing IMI (90.0% vs. 15.8%, OR: 25.712, p=0.009).
Conclusion: Rationale use of steroids, with appropriate indication, dose and duration is important in the treatment of severe COVID-19 pneumonia.
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