{"title":"Coronavirus Disease-19-associated Mucormycosis：对 69 名患者的单中心观察研究","authors":"Dhirendra Shivprasad Yadav, Swati Arvind Chavan, Niteen Dattatray Karnik, Chaya Ashok Kumar, Rupal Nilesh Padhiyar, Desma D'Souza","doi":"10.59556/japi.72.0684","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>We studied the clinical presentation, risk factors, complications, and in-hospital outcomes of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM).</p><p><strong>Materials and methods: </strong>A retrospective study was done on 69 COVID-19 patients with microbiologically proven mucormycosis admitted over a period of seven months from March 2021 to September 2021.</p><p><strong>Results: </strong>All 69 mucormycosis patients (46 males, 23 females) had reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection. Their mean age was 52.8 years, with mucormycosis developing in 51 patients (73.9%) within 30 days of COVID-19 infection; 7 (10.1%) were positive on admission. Rhino-orbital-cerebral mucormycosis (ROCM) was the most common (40.3%), followed by rhino-orbital (37.3%) and sinonasal (22.4%). Diabetes mellitus was present in 98.6% of patients. Common symptoms of mucormycosis were facial pain, headache, facial swelling, and vision loss. During COVID-19, 88.4 and 52.5% received immunosuppressive treatment and zinc sulfate, respectively; 34.7% needed intensive care unit (ICU) admission. The mortality rate was 26.1%. On multivariate logistic regression analysis, the presence of chronic kidney disease, leukocytosis, ophthalmoplegia, oral/palate ulceration, current need for invasive ventilation, and past duration of oxygen therapy and zinc supplementation were significantly associated with mortality. Patients with current COVID-19 infection had severe disease with increased need for intensive care (57.1 vs 14.5%) and higher mortality (57.1 vs 22.6%) compared to mucormycosis patients with previous COVID-19 infection.</p><p><strong>Interpretation and conclusion: </strong>Rhino-orbital-cerebral, rhino-orbital, and sinonasal were the most common presentations in cases of mucormycosis, with a mortality rate of 26.1%. COVID-19 coinfection predisposes patients with mucormycosis to severe disease with higher mortality.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 10","pages":"24-31"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Coronavirus Disease-19-associated Mucormycosis: A Single-center Observational Study of 69 Patients.\",\"authors\":\"Dhirendra Shivprasad Yadav, Swati Arvind Chavan, Niteen Dattatray Karnik, Chaya Ashok Kumar, Rupal Nilesh Padhiyar, Desma D'Souza\",\"doi\":\"10.59556/japi.72.0684\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>We studied the clinical presentation, risk factors, complications, and in-hospital outcomes of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM).</p><p><strong>Materials and methods: </strong>A retrospective study was done on 69 COVID-19 patients with microbiologically proven mucormycosis admitted over a period of seven months from March 2021 to September 2021.</p><p><strong>Results: </strong>All 69 mucormycosis patients (46 males, 23 females) had reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection. Their mean age was 52.8 years, with mucormycosis developing in 51 patients (73.9%) within 30 days of COVID-19 infection; 7 (10.1%) were positive on admission. Rhino-orbital-cerebral mucormycosis (ROCM) was the most common (40.3%), followed by rhino-orbital (37.3%) and sinonasal (22.4%). Diabetes mellitus was present in 98.6% of patients. Common symptoms of mucormycosis were facial pain, headache, facial swelling, and vision loss. During COVID-19, 88.4 and 52.5% received immunosuppressive treatment and zinc sulfate, respectively; 34.7% needed intensive care unit (ICU) admission. The mortality rate was 26.1%. On multivariate logistic regression analysis, the presence of chronic kidney disease, leukocytosis, ophthalmoplegia, oral/palate ulceration, current need for invasive ventilation, and past duration of oxygen therapy and zinc supplementation were significantly associated with mortality. Patients with current COVID-19 infection had severe disease with increased need for intensive care (57.1 vs 14.5%) and higher mortality (57.1 vs 22.6%) compared to mucormycosis patients with previous COVID-19 infection.</p><p><strong>Interpretation and conclusion: </strong>Rhino-orbital-cerebral, rhino-orbital, and sinonasal were the most common presentations in cases of mucormycosis, with a mortality rate of 26.1%. COVID-19 coinfection predisposes patients with mucormycosis to severe disease with higher mortality.</p>\",\"PeriodicalId\":22693,\"journal\":{\"name\":\"The Journal of the Association of Physicians of India\",\"volume\":\"72 10\",\"pages\":\"24-31\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of the Association of Physicians of India\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.59556/japi.72.0684\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of the Association of Physicians of India","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.59556/japi.72.0684","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的：我们研究了冠状病毒病2019（COVID-19）相关粘孢子菌病（CAM）患者的临床表现、风险因素、并发症和住院预后：我们研究了冠状病毒病2019（COVID-19）相关粘孢子菌病（CAM）患者的临床表现、风险因素、并发症和院内预后：对2021年3月至2021年9月7个月期间收治的69例经微生物学证实的COVID-19粘孢子菌病患者进行了回顾性研究：所有69名粘孢子菌病患者（46名男性，23名女性）均经逆转录酶聚合酶链反应（RT-PCR）证实感染了COVID-19。他们的平均年龄为52.8岁，51名患者（73.9%）在感染COVID-19后30天内患上粘孢子菌病；7名患者（10.1%）在入院时呈阳性。鼻-眶-脑粘液瘤病最常见（40.3%），其次是鼻-眶（37.3%）和鼻窦（22.4%）。98.6%的患者患有糖尿病。粘液瘤病的常见症状是面部疼痛、头痛、面部肿胀和视力下降。在COVID-19期间，88.4%和52.5%的患者分别接受了免疫抑制治疗和硫酸锌治疗；34.7%的患者需要入住重症监护室（ICU）。死亡率为 26.1%。多变量逻辑回归分析显示，慢性肾病、白细胞增多症、眼球震颤、口腔/腭部溃疡、目前需要有创通气、过去接受氧疗和补锌治疗的时间与死亡率显著相关。与既往感染过COVID-19的粘液瘤患者相比，目前感染过COVID-19的患者病情严重，需要更多的重症监护（57.1% vs 14.5%），死亡率更高（57.1% vs 22.6%）：解释与结论：鼻-眶-脑、鼻-眶和鼻窦是粘孢子菌病病例中最常见的表现形式，死亡率为26.1%。COVID-19合并感染易使粘孢子菌病患者病情严重，死亡率较高。
Coronavirus Disease-19-associated Mucormycosis: A Single-center Observational Study of 69 Patients.
Background and objectives: We studied the clinical presentation, risk factors, complications, and in-hospital outcomes of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM).
Materials and methods: A retrospective study was done on 69 COVID-19 patients with microbiologically proven mucormycosis admitted over a period of seven months from March 2021 to September 2021.
Results: All 69 mucormycosis patients (46 males, 23 females) had reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection. Their mean age was 52.8 years, with mucormycosis developing in 51 patients (73.9%) within 30 days of COVID-19 infection; 7 (10.1%) were positive on admission. Rhino-orbital-cerebral mucormycosis (ROCM) was the most common (40.3%), followed by rhino-orbital (37.3%) and sinonasal (22.4%). Diabetes mellitus was present in 98.6% of patients. Common symptoms of mucormycosis were facial pain, headache, facial swelling, and vision loss. During COVID-19, 88.4 and 52.5% received immunosuppressive treatment and zinc sulfate, respectively; 34.7% needed intensive care unit (ICU) admission. The mortality rate was 26.1%. On multivariate logistic regression analysis, the presence of chronic kidney disease, leukocytosis, ophthalmoplegia, oral/palate ulceration, current need for invasive ventilation, and past duration of oxygen therapy and zinc supplementation were significantly associated with mortality. Patients with current COVID-19 infection had severe disease with increased need for intensive care (57.1 vs 14.5%) and higher mortality (57.1 vs 22.6%) compared to mucormycosis patients with previous COVID-19 infection.
Interpretation and conclusion: Rhino-orbital-cerebral, rhino-orbital, and sinonasal were the most common presentations in cases of mucormycosis, with a mortality rate of 26.1%. COVID-19 coinfection predisposes patients with mucormycosis to severe disease with higher mortality.
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