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COVID-19 相关毛霉菌病:全球及印度病例报告的系统综述。

Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India.

机构信息

Department of Diabetes & Endocrinology, G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India.

Department of Diabetes & Endocrinology, G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India.

出版信息

Diabetes Metab Syndr. 2021 Jul-Aug;15(4):102146. doi: 10.1016/j.dsx.2021.05.019. Epub 2021 May 21.


DOI:10.1016/j.dsx.2021.05.019
PMID:34192610
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8137376/
Abstract

BACKGROUND AND AIMS: There are increasing case reports of rhino-orbital mucormycosis in people with coronavirus disease 2019 (COVID-19), especially from India. Diabetes mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. We aim to conduct a systematic review of literature to find out the patient's characteristics having mucormycosis and COVID-19. METHODS: We searched the electronic database of PubMed and Google Scholar from inception until May 13, 2021 using keywords. We retrieved all the granular details of case reports/series of patients with mucormycosis, and COVID-19 reported world-wide. Subsequently we analyzed the patient characteristics, associated comorbidities, location of mucormycosis, use of steroids and its outcome in people with COVID-19. RESULTS: Overall, 101 cases of mucormycosis in people with COVID-19 have been reported, of which 82 cases were from India and 19 from the rest of the world. Mucormycosis was predominantly seen in males (78.9%), both in people who were active (59.4%) or recovered (40.6%) from COVID-19. Pre-existing diabetes mellitus (DM) was present in 80% of cases, while concomitant diabetic ketoacidosis (DKA) was present in 14.9%. Corticosteroid intake for the treatment of COVID-19 was recorded in 76.3% of cases. Mucormycosis involving nose and sinuses (88.9%) was most common followed by rhino-orbital (56.7%). Mortality was noted in 30.7% of the cases. CONCLUSION: An unholy trinity of diabetes, rampant use of corticosteroid in a background of COVID-19 appears to increase mucormycosis. All efforts should be made to maintain optimal glucose and only judicious use of corticosteroids in patients with COVID-19.

摘要

背景与目的:越来越多的报道称,2019 年冠状病毒病(COVID-19)患者中出现了鼻-眶-脑毛霉菌病(rhino-orbital mucormycosis,ROM),尤其是来自印度的报道。糖尿病(diabetes mellitus,DM)是 COVID-19 重症和毛霉菌病的独立危险因素。我们旨在进行系统评价文献,以发现患有毛霉菌病和 COVID-19 的患者特征。

方法:我们使用关键词从电子数据库 PubMed 和 Google Scholar 中检索了截至 2021 年 5 月 13 日的文献。我们检索了全球范围内报道的所有患有毛霉菌病和 COVID-19 的病例报告/病例系列的详细资料。随后,我们分析了 COVID-19 患者中毛霉菌病的患者特征、相关合并症、毛霉菌病的部位、皮质类固醇的使用及其结局。

结果:总体而言,报道了 101 例 COVID-19 患者并发毛霉菌病,其中 82 例来自印度,19 例来自世界其他地区。毛霉菌病主要发生在男性(78.9%)中,这些患者或为 COVID-19 活动期(59.4%),或为恢复期(40.6%)。80%的病例存在糖尿病,同时伴有糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的占 14.9%。记录了 76.3%的病例使用皮质类固醇治疗 COVID-19。最常见的是鼻和鼻窦受累(88.9%),其次是鼻-眶(56.7%)。30.7%的病例死亡。

结论:糖尿病、COVID-19 背景下大剂量使用皮质类固醇的“三因素致病组合”似乎增加了毛霉菌病的发生风险。应尽力保持血糖最佳,仅在 COVID-19 患者中谨慎使用皮质类固醇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7c7/8137376/094125cd5921/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7c7/8137376/094125cd5921/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7c7/8137376/094125cd5921/gr1_lrg.jpg

相似文献

[1]
Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India.

Diabetes Metab Syndr. 2021

[2]
Black fungus immunosuppressive epidemic with Covid-19 associated mucormycosis (zygomycosis): a clinical and diagnostic perspective from India.

Immunogenetics. 2022-4

[3]
Diabetes, COVID 19 and mucormycosis: Clinical spectrum and outcome in a tertiary care medical center in Western India.

Diabetes Metab Syndr. 2021

[4]
Rhino-orbital-cerebral-mucormycosis in COVID-19: A systematic review.

Indian J Pharmacol. 2021

[5]
A systematic review of mucormycosis cases in COVID-19: Is it an unholy trilogy of COVID-19, diabetes mellitus, and corticosteroids?

J Family Med Prim Care. 2022-6

[6]
Absence of Case of Mucormycosis (March 2020-May 2021) under strict protocol driven management care in a COVID-19 specific tertiary care intensive care unit.

Diabetes Metab Syndr. 2021

[7]
Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World.

Mycopathologia. 2021-12

[8]
COVID-19 associated mucormycosis - An emerging threat.

J Microbiol Immunol Infect. 2022-4

[9]
COVID-19 and mucormycosis superinfection: the perfect storm.

Infection. 2021-10

[10]
COVID-19-associated rhino-orbital-cerebral mucormycosis: A systematic review, meta-analysis, and meta-regression analysis.

Indian J Pharmacol. 2021

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Microb Cell. 2025-8-12

[2]
A Clinico-Demographic Study of Mucormycosis Cases Admitted in a Tertiary Care Government Hospital in Western Maharashtra.

Indian J Community Med. 2025

[3]
Risk factors for COVID-19-associated mucormycosis (CAM): A case-control study.

J Family Med Prim Care. 2025-7

[4]
Mucormycosis and Hearing: A Hospital-Based Study.

Int Arch Otorhinolaryngol. 2025-8-7

[5]
Craniofacial Involvement of Mucormycosis: A Single-Center Experience of 57 Cases From Shiraz, Iran.

Can J Infect Dis Med Microbiol. 2025-7-30

[6]
Mucormycosis in patients infected with the delta strain of COVID-19 virus, effective of some factors in the prevalence and patient prognosis in Shahid Beheshti Hospital, Kashan, central Iran.

Caspian J Intern Med. 2025-3-11

[7]
Rhino-Orbital Mucormycosis With Delayed Diagnosis in an Immunocompromised Patient: A Case Report.

Cureus. 2025-5-23

[8]
Uncovering the antifungal potential of Cannabidiol and Cannabidivarin.

PLoS Negl Trop Dis. 2025-6-5

[9]
Outcomes of surgical management in orbital cellulitis due to mucormycosis in patients recovered from COVID-19.

Indian J Ophthalmol. 2025-6-1

[10]
Association of Markers of iron Metabolism with Mucormycosis: A Case Control Study.

Indian J Otolaryngol Head Neck Surg. 2025-6

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