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毛霉菌病、糖尿病和新冠肺炎关联背后的巧合还是现实:一项系统综述

Coincidence or reality behind Mucormycosis, diabetes mellitus and Covid-19 association: A systematic review.

作者信息

Sengupta Indraneel, Nayak Tilak

机构信息

Department of Life Science and Biotechnology, Jadavpur University, Kolkata 700032, India.

Department of Life Science and Biotechnology, Jadavpur University, Kolkata 700032, India.

出版信息

J Mycol Med. 2022 Aug;32(3):101257. doi: 10.1016/j.mycmed.2022.101257. Epub 2022 Feb 18.

Abstract

Mucormycosis is a rare but life-threatening disease with high morbidity and mortality and is difficult to diagnose. Mucormycosis, is a severe but rare fungal infection caused by a group of molds called mucormycetes. Diabetes, use of corticosteroids, metabolic/diabetic acidosis and Covid-19 mediated immunosuppression are reported in more than 70% of cases in mucormycosis patients. Coexisting mucormycosis, Covid-19 along with diabetes mellitus increase the likelihood of mortality. Despite its occurrence since the beginning of the pandemic, there are still unanswered concerns regarding the origin of this fungal infection and mortality rate and/or relation with diabetic patients. In this review, we describe the detailed view of causative pathogens responsible for mucormycosis, diabetes mellitus and Covid-19 association along with the morbidity cases during the latest Covid-19 crisis. In the case of mucormycosis diagnosis, imaging, histopathological confirmation, fungal culture and molecular identification methods should be considered. Once mucormycosis is diagnosed, a combined treating method consisting of antifungals administration like amphotericin B, surgical intervention is needed for the reversal of the underlying condition. Early detection of this potentially life-threatening infection and timely care is needed in lowering mortality rates.

摘要

毛霉病是一种罕见但危及生命的疾病,发病率和死亡率高,且难以诊断。毛霉病是由一组称为毛霉菌的霉菌引起的严重但罕见的真菌感染。超过70%的毛霉病患者有糖尿病、使用皮质类固醇、代谢性/糖尿病性酸中毒以及新冠病毒介导的免疫抑制情况。同时存在毛霉病、新冠病毒感染以及糖尿病会增加死亡的可能性。尽管自疫情开始以来就有这种疾病出现,但关于这种真菌感染的起源、死亡率和/或与糖尿病患者的关系仍存在未解决的问题。在本综述中,我们描述了导致毛霉病的病原体、糖尿病与新冠病毒感染之间关联的详细情况,以及最新新冠疫情期间的发病案例。对于毛霉病的诊断,应考虑影像学检查、组织病理学确认、真菌培养和分子鉴定方法。一旦诊断出毛霉病,需要采用包括使用两性霉素B等抗真菌药物治疗以及手术干预在内的综合治疗方法来扭转病情。早期发现这种潜在的危及生命的感染并及时治疗对于降低死亡率至关重要。

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