Kant Ravi, Totaganti Manjunath, Mohan Bharati, Bairwa Mukesh, Panda Prasan K, Tyagi Amit, Prasad Amber, Bahurupi Yogesh
Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Cureus. 2022 Jun 4;14(6):e25652. doi: 10.7759/cureus.25652. eCollection 2022 Jun.
Background Fungal infection in patients with coronavirus disease 2019 (COVID-19) has emerged as a new challenge in healthcare facilities. This study aimed to describe the demographic and clinical characteristics of COVID-19-associated mucormycosis (CAM). Methodology This retrospective, single-center case series included patients who were hospitalized and diagnosed with COVID-19 and mucormycosis at the All India Institute of Medical Sciences, Rishikesh (North India) from April 15, 2021, onwards and last followed up on June 30, 2021. Demographic, clinical, laboratory, radiological, microbiological, pathological, and outcome data were then collected and analyzed. Results Of the 100 consecutive inpatients with CAM, 95 (95%) had diabetes mellitus. At the onset of illness, the most common manifestations were facial swelling (85%), eye swelling (83%), headache (68%), pain around the eyeball (67%), malaise (57%), and fever (50%). The most common organ involved on examination was the nose and paranasal sinus (96%), followed by the orbit (83%), palate (19%), and cranial nerves (7%). Pulmonary involvement was seldom observed (1%). Predominant pathological findings were the presence of aseptate hyphae (75%), necrosis (75%), angioinvasion (36%), and perineural invasion (2.6%). During the last follow-up, 13 patients died, with 11 (84.6%) having severe COVID-19 and two (15.3%) having moderate COVID-19. Conclusions Steroid use and diabetes mellitus are the significant risk factors of CAM. Patients with CAM usually present with face/eye swelling with radiological involvement of the nose and sinus and may die because of severe COVID-19.
2019冠状病毒病（COVID-19）患者的真菌感染已成为医疗机构面临的新挑战。本研究旨在描述COVID-19相关毛霉病（CAM）的人口统计学和临床特征。方法：本回顾性单中心病例系列研究纳入了2021年4月15日起在印度北里希凯什全印医学科学研究所住院并被诊断为COVID-19和毛霉病的患者，最后随访时间为2021年6月30日。然后收集并分析人口统计学、临床、实验室、放射学、微生物学、病理学和结局数据。结果：在100例连续的CAM住院患者中，95例（95%）患有糖尿病。发病时，最常见的表现为面部肿胀（85%）、眼部肿胀（83%）、头痛（68%）、眼球周围疼痛（67%）、不适（57%）和发热（50%）。检查中最常受累的器官是鼻和鼻窦（96%），其次是眼眶（83%）、腭（19%）和脑神经（7%）。很少观察到肺部受累（1%）。主要病理表现为无隔菌丝（75%）、坏死（75%）、血管侵袭（36%）和神经周围侵袭（2.6%）。在最后一次随访时，13例患者死亡，其中11例（84.6%）患有重症COVID-19，2例（15.3%）患有中度COVID-19。结论：使用类固醇和糖尿病是CAM的重要危险因素。CAM患者通常表现为面部/眼部肿胀，伴有鼻和鼻窦的放射学受累，可能因重症COVID-19而死亡。
