COVID-19患者的毛霉病

A. I. Nerovnyi, I. G. Panchenko, M. V. Morenko, A. V. Fedin, E. V. Polyukhov, A. V. Sycheva
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引用次数: 1

摘要

鼻-脑毛霉菌病病程严重,是COVID-19患者的晚期并发症之一。为了成功治疗本病,需要尽早诊断并预约特异性保守治疗并结合手术干预。目标。研究SARS-CoV-2感染患者发生侵袭性真菌病的危险因素、临床表现及治疗结果。研究方法。回顾性分析25例毛霉病患者的病史。对人口统计学、主观和客观数据(病史、主诉、内窥镜检查)、放射学技术(CT扫描)、组织学、显微镜和文化研究以及内科和外科治疗结果进行了分析。研究结果。确定了可能易患此病的共病病理患者组,以及易患毛霉病风险的药物组。结论。发生毛霉病的易感背景是高血糖状况以及在COVID-19治疗方案中使用高剂量皮质类固醇和广谱抗生素。流行病学资料显示,侵袭性鼻-脑毛霉菌病病例最多的病例与高毒力的SARS-CoV-2 δ型病毒相吻合。早期特异性抗真菌治疗结合手术治疗效果更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mucormycosis in patients with COVID-19
Rhinocerebral mucormycosis is characterized by a severe course and is one of the late complications in patients who have undergone COVID-19. For the successful treatment of this disease, the earliest possible diagnosis and the appointment of specific conservative therapy in combination with surgical intervention are necessary. Objective. To study the risk factors for the development of invasive mycoses, the clinical manifestations of this pathology, and the results of its treatment in patients who underwent SARS-CoV-2. Research methods. Retrospective analysis of the case histories of 25 patients with mucormycosis. Demographic, subjective, and objective data (medical history, complaints, endoscopic examination), radiological techniques (CT scans), histological, microscopic and cultural studies as well as the results of medical and surgical treatment were analyzed. Result of the study. Groups of patients with comorbid pathology, potentially predisposed to the development of this disease, as well as groups of drugs, the use of which predisposes to the risk of developing mucormycosis, were identified. Conclusion. The predisposing background to the development of mucormycosis is hyperglycemic conditions and the use of high doses of corticosteroids and broad-spectrum antibiotics as part of the COVID-19 treatment protocol. According to epidemiological data, the largest number of cases of invasive rhinocerebral mucormycosis coincided with the highly virulent SARS-CoV-2 delta strain. Early initiation of specific antifungal therapy combined with surgery results in more effective treatment.
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