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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引用次数: 0
摘要
背景：侵袭性霉菌感染（IMI）在COVID-19重症肺炎患者中很常见，诊断和治疗困难，死亡率高。目的：本研究的目的是确定与COVID-19相关的侵袭性霉菌感染的危险因素。方法：本前瞻性病例对照研究将重症监护病房中合并侵袭性霉菌感染的重症COVID-19肺炎患者与无继发感染（细菌或真菌）的重症COVID-19肺炎患者进行比较。比较人口统计学、接受的治疗和结果。结果：IMI组20例，对照组19例。侵袭性曲霉病13例（65.0%），毛霉病7例（35.0%）。IMI组与对照组的人口统计学和临床特征相似（p < 0.05）。IMI组28天死亡率为60.0%，对照组为15.8% （p=0.005）。类固醇的使用已被确定为发生IMI的最重要危险因素（90.0% vs 15.8%, OR: 25.712, p=0.009）。结论：合理使用类固醇，适当的适应证、剂量和持续时间是治疗COVID-19重症肺炎的重要因素。
Risk factors for invasive mold infection after COVID-19: case-control study.
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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