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COVID-19 时代的 ROCM(鼻眶脑毛霉菌病)流行的手术和医学管理及其结果- 一家三级护理中心的经验。

Surgical & medical management of ROCM (Rhino-orbito-cerebral mucormycosis) epidemic in COVID-19 era and its outcomes - a tertiary care center experience.

机构信息

Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.

Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.

出版信息

J Mycol Med. 2022 May;32(2):101238. doi: 10.1016/j.mycmed.2021.101238. Epub 2021 Dec 25.

Abstract

OBJECTIVE

To evaluate the outcome of patients with ROCM (Rhino-orbito-cerebral mucormycosis) following their medical and surgical management.

MATERIALS AND METHODS

It is a prognostic study based in a tertiary care center in North-Western India. Patients who developed ROCM post COVID-19 infection from 1st September 2020 to 30th June 2021 were included in this study. Surgical debridement and administration of antifungal therapy was done for the post-COVID-19 ROCM patients. Disease progression and survival was studied up to 5 months of follow-up in the second wave.

RESULTS

A total of 145 ROCM patients were included. The mean age at presentation, male: female ratio was 48.2 years and 2:1 respectively. As per our proposed new staging system and treatment strategy, the majority of patients belonged to stage II (31.72%) and stage III (31.03%). On a follow-up period of 5 months, 26 (18%) patients have lost their life and rest of the patients are on strict follow-up.

CONCLUSION

ROCM is an extremely aggressive fungal infection which rapidly became an epidemic following the COVID-19 pandemic. The diverse and unique presentation led us to evolve a new strategy to classify and manage these patients.

摘要

目的

评估接受医学和手术治疗的 ROCM(鼻眶脑毛霉菌病)患者的结局。

材料和方法

这是一项在印度西北部一家三级护理中心进行的预后研究。本研究纳入了 2020 年 9 月 1 日至 2021 年 6 月 30 日期间因 COVID-19 感染后发生 ROCM 的患者。对 COVID-19 相关 ROCM 患者进行手术清创和抗真菌治疗。在第二波疫情中,对患者进行了为期 5 个月的随访,以研究疾病进展和生存情况。

结果

共纳入 145 例 ROCM 患者。发病时的平均年龄、男女比例分别为 48.2 岁和 2:1。根据我们提出的新分期系统和治疗策略,大多数患者属于 II 期(31.72%)和 III 期(31.03%)。在 5 个月的随访期内,有 26 名(18%)患者死亡,其余患者正在接受严格随访。

结论

ROCM 是一种极具侵袭性的真菌感染,在 COVID-19 大流行后迅速流行起来。其多样化和独特的表现促使我们制定了一种新的策略来对这些患者进行分类和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab4/8709922/024123f5481e/gr1_lrg.jpg

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