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新型冠状病毒肺炎相关毛霉菌病、糖尿病与类固醇治疗:墨西哥西部单一中心的经验

COVID-19-associated mucormycosis, diabetes and steroid therapy: Experience in a single centre in Western Mexico.

作者信息

Guzmán-Castro Salvador, Chora-Hernandez Luis David, Trujillo-Alonso Gersain, Calvo-Villalobos Ivan, Sanchez-Rangel Antonio, Ferrer-Alpuin Edgar, Ruiz-Jimenez Miguel, Corzo-Leon Dora E

机构信息

Hospital General "Dr. Miguel Silva" SSM, Morelia, Mexico.

Microbiology Gerency, Asesores Diagnóstico Clínico, Puebla, Mexico.

出版信息

Mycoses. 2022 Jan;65(1):65-70. doi: 10.1111/myc.13383. Epub 2021 Oct 28.

Abstract

BACKGROUND

COVID-19-associated mucormycosis (CAM) has emerged as a challenging complication as the current pandemic has increased the population requiring treatment with corticosteroids. CAM has caused a massive outbreak in India, reported to be causing cases in Iran, Egypt and The Netherlands.

OBJECTIVES

To describe CAM cases occurring in a single centre in Western Mexico.

METHODS

Our group carried out a retrospective study from May 2020 to May 2021 to identify CAM cases in patients with previous COVID-19 diagnosis.

RESULTS

Six CAM cases occurred in a single centre in Western Mexico during the study period, most of them with diabetes (n = 5/6) and all received corticosteroid therapy even when only three had severe COVID-19. After analysing local COVID-19 burden, it was estimated that in this region, CAM was 300 times more frequent among COVID individuals than the estimates for general population.

CONCLUSION

Similar to large reports in India and other countries, CAM cases reported in this study were diagnosed in individuals with diabetes, hyperglycaemic status and with history of previous use of corticosteroids. Identifying these individuals at risk can help the early identification of CAM. In addition, strict glycaemic control and avoidance of unnecessary corticosteroid in non-severe COVID-19 cases could help in preventing this complicated fungal infection.

摘要

背景

随着当前疫情导致需要使用皮质类固醇进行治疗的人群增加,新型冠状病毒肺炎相关毛霉菌病(CAM)已成为一种具有挑战性的并发症。CAM在印度引发了大规模疫情,据报道在伊朗、埃及和荷兰也有病例出现。

目的

描述墨西哥西部一个单一中心发生的CAM病例。

方法

我们的团队在2020年5月至2021年5月期间进行了一项回顾性研究,以确定先前诊断为新型冠状病毒肺炎的患者中的CAM病例。

结果

在研究期间,墨西哥西部的一个单一中心出现了6例CAM病例,其中大多数患有糖尿病(n = 5/6),并且即使只有3例患有重症新型冠状病毒肺炎,所有患者均接受了皮质类固醇治疗。在分析当地新型冠状病毒肺炎负担后,据估计,在该地区,新型冠状病毒肺炎患者中CAM的发病率是普通人群估计发病率的300倍。

结论

与印度和其他国家的大型报告相似,本研究报告的CAM病例是在患有糖尿病、血糖升高且有先前使用皮质类固醇病史的个体中诊断出来的。识别这些高危个体有助于早期发现CAM。此外,在非重症新型冠状病毒肺炎病例中严格控制血糖并避免不必要的皮质类固醇使用可能有助于预防这种复杂的真菌感染。

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