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一项横断面研究,旨在描述印度东部一家三级医院就诊的毛霉菌病的眼部表现和危险因素谱。

A cross-sectional study to describe the spectrum of ocular manifestations and risk factors of mucormycosis presenting to a tertiary hospital of East India.

机构信息

Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India.

Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India.

出版信息

Indian J Ophthalmol. 2023 Jan;71(1):249-256. doi: 10.4103/ijo.IJO_1699_22.

Abstract

PURPOSE

To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the "second wave" of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute.

METHODS

Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0.

RESULTS

A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation.

CONCLUSION

Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.

摘要

目的

报告印度东部 COVID-19 大流行“第二波”期间发生的鼻-眶-脑毛霉菌病(ROCM)患者的临床-人口统计学特征,以及他们在就诊于我们的三级医院时的眼部表现。

方法

根据住院记录,对我院就诊的患者进行横断面研究。将人口统计学信息、与 COVID-19 相关的病史、详细眼部检查记录、微生物学、影像学和组织病理学检查结果录入在线工作表,并使用 SPSS 26.0 进行分析。

结果

2021 年 5 月至 9 月共治疗了 219 例 ROCM 患者,其中 110 例在就诊时存在眼部表现(50.2%)。患者年龄为 22 岁至 83 岁,平均年龄±标准差(SD)为 49.9±12.9 岁。90 例(81.8%)患者被诊断为糖尿病,31 例(34%)患有高血压,10 例患者有其他合并症。COVID-19 发病至毛霉菌病症状出现的时间为 0 至 60 天,平均±SD 间隔为 20.9±12.6 天。56 例(50.9%)患者有类固醇使用史。持续的眼部或面部疼痛是最常见的首发症状,上睑下垂是最常见的前节表现,眼动脉闭塞是最常见的后节表现。

结论

我们来自印度东部的数据证实了 COVID-19、糖尿病、皮质类固醇使用与 ROCM 之间的关系。了解本研究中描述的该病各种不同的前节和后节表现,将有助于临床医生早期识别该病,并尽一切努力预防并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ee/10155590/8ea72ea82679/IJO-71-249-g001.jpg

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