Departmentof Otorhinolaryngology, Loghman Hakim Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ear Nose Throat J. 2024 Jun;103(1_suppl):145S-152S. doi: 10.1177/01455613221143859. Epub 2022 Dec 29.
Mucormycosis is an opportunistic fungal disease that affects immunocompromised patients. With the advent of SARS-CoV-2, this opportunistic disease has increased.
A case series of 47 patients with COVID-19 associated mucormycosis have been analyzed. Demographic information, signs, symptoms, laboratory investigations, imaging studies, and their association with ICU admission and 30-day mortality were assessed.
Total number of 47 consecutive rhino-orbital cerebral mucormycosis (ROCM) cases were analyzed. Periorbital swelling was the most common sign among patients. Majority of cases had diabetes. All patients received liposomal Amphotericin B. Debridement was performed for all cases.
SARS-CoV-2 increases the susceptibility to mucormycosis infection in various ways. Uncontrolled level of HbA1c in all patients, even non-diabetic individuals, indicates hyperglycemia over the past three months. Diabetes, orbital exenteration, ptosis, periorbital swelling, DKA, LOC, brain involvement, and mechanical ventilation all correlated with a higher rate of ICU admission and 30-day mortality. In addition, a higher white blood cell count is related to the higher probability of ICU admission. While considering all of the inflammatory laboratory data and HbA1c could help predict 30-day mortality.
毛霉菌病是一种机会性真菌感染疾病，影响免疫功能低下的患者。随着 SARS-CoV-2 的出现，这种机会性疾病有所增加。
分析了 47 例 COVID-19 相关毛霉菌病患者的病例系列。评估了人口统计学信息、体征、症状、实验室检查、影像学研究及其与 ICU 入院和 30 天死亡率的关系。
共分析了 47 例连续的鼻眶脑毛霉菌病（ROCM）病例。眶周肿胀是患者最常见的体征。大多数病例有糖尿病。所有患者均接受脂质体两性霉素 B 治疗。所有病例均行清创术。
SARS-CoV-2 通过多种方式增加了对毛霉菌感染的易感性。所有患者（甚至非糖尿病患者）的 HbA1c 均未得到控制，表明过去三个月存在高血糖。糖尿病、眼眶内容物剜除术、上睑下垂、眶周肿胀、DKA、LOC、脑部受累和机械通气均与 ICU 入院和 30 天死亡率的增高相关。此外，白细胞计数较高与 ICU 入院的可能性较高相关。考虑所有炎症性实验室数据和 HbA1c 有助于预测 30 天死亡率。
