Irfan Ayesha, Kamran Afshan Hussain, Ammar Muhammad, Rahman Saeed Ur
Department of Oral Pathology Fatima Memorial College of Medicine and Dentistry Lahore Pakistan.
Department of Oral Pathology, Lahore General Hospital Postgraduate Medical Institute Lahore Pakistan.
Health Sci Rep. 2023 Feb 3;6(2):e1083. doi: 10.1002/hsr2.1083. eCollection 2023 Feb.
Mucormycosis is a serious fungal infection associated with uncontrolled diabetes and immunocompromised patients. This angioinvasive infection emerged as a post-covid complication worldwide especially in developing countries. Due to the common socio-demographic status of South Asian countries, we expected a surge in mucormycosis cases in Pakistan. This study aims to observe the frequency and survival of Covid associated mucormycosis patients at tertiary care hospitals in Pakistan during the third wave of Covid-19 in 2021.
In this retrospective study, we collected the data of clinically and histopathologically confirmed cases of rhino-occipito-cerebral mucormycosis from three tertiary care hospitals of Lahore. These cases were analysed for history of Covid-19 and other associated comorbidities using SPSS28. History of steroid medication was also taken. Data were retrieved from May to July 2021 after the approval from the ethical review board.
Out of the total 43 reported patients of mucormycosis in the set time frame only 22 cases had a history of Covid-19. The mean age was 50 ± 13.27 years with slight male predilection (60%). Diabetes mellitus was the most common comorbidity (88.4%) and all the patients with covid associated mucormycosis (CAM) had taken corticosteroid regimen for covid management ( < 0.0001). The survival of the patient was not significantly different between CAM and non-CAM patients of Mucormycosis ( = 0.747).
Covid-19 and mucormycosis make a lethal duo against the weakened health system of Pakistan. This problem can be prevented by avoiding nonjudicial use of corticosteroids and proper diabetes control program following Covid-19 infection. Furthermore, large-scale epidemiological studies should be carried out to evaluate the true burden of Mucormycosis in the population.
毛霉菌病是一种与糖尿病控制不佳和免疫功能低下患者相关的严重真菌感染。这种血管侵袭性感染在全球范围内作为新冠后遗症出现,尤其是在发展中国家。由于南亚国家的社会人口状况相似,我们预计巴基斯坦的毛霉菌病病例会激增。本研究旨在观察2021年新冠疫情第三波期间,巴基斯坦三级医院中新冠相关毛霉菌病患者的发病频率和生存率。
在这项回顾性研究中,我们收集了拉合尔三家三级医院临床和组织病理学确诊的鼻枕脑型毛霉菌病病例的数据。使用SPSS28对这些病例进行了新冠病史和其他相关合并症的分析。还记录了类固醇药物使用史。经伦理审查委员会批准后,于2021年5月至7月检索数据。
在规定时间内报告的43例毛霉菌病患者中,只有22例有新冠病史。平均年龄为50±13.27岁,男性略多(60%)。糖尿病是最常见的合并症(88.4%),所有新冠相关毛霉菌病(CAM)患者都接受了用于新冠治疗的皮质类固醇方案(<0.0001)。毛霉菌病的CAM患者和非CAM患者的生存率无显著差异(=0.747)。
新冠和毛霉菌病对巴基斯坦薄弱的卫生系统构成致命组合。通过避免不合理使用皮质类固醇以及在新冠感染后实施适当的糖尿病控制计划,可以预防这个问题。此外,应开展大规模流行病学研究,以评估毛霉菌病在人群中的真实负担。