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伊朗中部2年新冠疫情期间的鼻-鼻窦毛霉菌病:发病率及临床特征

Sinonasal mucormycosis during 2 years of COVID-19 pandemic in central Iran: incidence rate and clinical features.

作者信息

Dadgarnia Mohammadhossein, Mandegari Mohammad, Baradaranfar Mohammadhossein, Vaziribozorg Sedighe, Abdollahpour Mahsa

机构信息

Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Acta Otorrinolaringol Esp (Engl Ed). 2023 Sep-Oct;74(5):298-304. doi: 10.1016/j.otoeng.2023.03.005. Epub 2023 Mar 24.

Abstract

INTRODUCTION

As a novel infectious disease, COVID-19 is caused by SARS-COV-2, spreading rapidly worldwide. ENT specialists have faced this challenging disease in various ways since the emergence of the COVID-19 pandemic. We are currently facing an increase in cases referred due to sinonasal mucormycosis which is a rare but invasive, rapidly progressive, and life-threatening infection. We provide an overview of this disease's incidence rate and clinical features.

METHODS

This descriptive cross-sectional study was conducted on 46 sinonasal mucormycosis patients who were histopathologically confirmed after sinonasal endoscopic surgery in our educational therapeutic hospital during 2 years of the COVID-19 pandemic from March 20, 2020, to March 20, 2022.

RESULTS

There was an increase in the incidence of mucormycosis more than twice as much as before. All patients had a history of COVID-19 and 69.6% were diabetic. The median time to symptom onset from COVID-19 detection was 3.3 weeks. A total of 60.9% received steroids while 85.7% were prescribed during COVID-19 treatment. The most common manifestation was orbital involvement (80.4%). Of the 46 study cases, unfortunately, 17 (37%) died. An exciting point in our study was the incidence of peripheral facial palsy which is associated involvement of multiple other cranial nerves (II, III, IV, V, VI) considered to be the likely occurrence of a rare phenomenon called Garcin's syndrome.

CONCLUSION

Based on the results of this study, during 2 years of the COVID -19 pandemic, there was an increase in the incidence of sinonasal mucormycosis more than twice as much as before.

摘要

引言

作为一种新型传染病,新型冠状病毒肺炎(COVID-19)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,在全球迅速传播。自COVID-19大流行出现以来,耳鼻喉科专家以各种方式应对这一具有挑战性的疾病。我们目前面临着因鼻窦毛霉菌病转诊病例的增加,这是一种罕见但具有侵袭性、进展迅速且危及生命的感染。我们概述了这种疾病的发病率和临床特征。

方法

本描述性横断面研究针对46例鼻窦毛霉菌病患者进行,这些患者在2020年3月20日至2022年3月20日的COVID-19大流行的2年期间,于我们的教学治疗医院接受鼻窦内窥镜手术后经组织病理学确诊。

结果

毛霉菌病的发病率增加了两倍多。所有患者都有COVID-19病史,69.6%为糖尿病患者。从COVID-19检测到症状出现的中位时间为3.3周。共有60.9%的患者接受了类固醇治疗,85.7%是在COVID-19治疗期间开具的。最常见的表现是眼眶受累(80.4%)。在46例研究病例中,不幸的是,17例(37%)死亡。我们研究中的一个令人关注的点是周围性面神经麻痹的发生率,它与其他多条颅神经(II、III、IV、V、VI)受累有关,被认为可能是一种名为加欣综合征的罕见现象的发生。

结论

基于本研究结果,在COVID-19大流行的2年期间,鼻窦毛霉菌病的发病率增加了两倍多。

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