Chemudugunta Rajkumar, Bindu Channabasappa, Indrani K, Ramesh B Hanumanthappa
Department of Pathology, Raichur Institute of Medical Sciences, Raichur, Karnataka, India.
Department of Oral and Maxillofacial Surgery, M R Ambedkar Dental College, Bengaluru, Karnataka, India.
J Oral Maxillofac Pathol. 2022 Oct-Dec;26(4):593. doi: 10.4103/jomfp.jomfp_425_21. Epub 2022 Dec 22.
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome (SARS-CoV-2), has become an emergency global public health issue. Disease pattern of COVID-19 ranges from mild to life-threatening pneumonia with associated bacterial and fungal coinfections. Due to associated comorbidities (e.g., diabetes mellitus and chronic obstructive pulmonary disease) and immunocompromised conditions (e.g., corticosteroid therapy), these patients are prone to develop severe opportunistic infections.
The aim of this study was to investigate the incidence of fungal coinfection of hospitalized patients with COVID-19 infection (SARS-CoV-2) in RIMS, Raichur.
Our study included 94 patients with invasive fungal infection who presented with either COVID-19 infection or had recovered from COVID-19 infection. Tissue samples from suspected sites were received in formalin for histopathological examination, and these were stained stains with hematoxylin and eosin and with periodic acid-Schiff/Gomori's methenamine silver wherever required.
A total of 94 biopsies were received with clinical suspicion of mucormycosis. Out of these, 52 (55.3%) were positive for mucormycosis and 42 (44.7%) were negative. Out of 52 positive cases, 46 (88.4%) were males and 6 (11.6%) were females. The highest number of cases was seen in age group of 51-60 years (26.92%). Out of the 52 positive cases, KOH mount was positive for fungal elements in 8 cases and negative for fungal elements in 29 cases.
Uncontrolled diabetes and overzealous use of steroids are two of the main factors aggravating the incidence of mucormycosis in COVID-19 patients. Early surgical intervention, histopathological confirmation and rapid and judicious intravenous antifungal treatment should be initiated for better patient outcomes.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）已成为全球紧急公共卫生问题。COVID-19的疾病模式从轻度到危及生命的肺炎不等，并伴有相关的细菌和真菌合并感染。由于存在相关合并症（如糖尿病和慢性阻塞性肺疾病）以及免疫功能低下状况（如皮质类固醇治疗），这些患者容易发生严重的机会性感染。
本研究的目的是调查赖丘尔地区RIMS医院中COVID-19感染（SARS-CoV-2）住院患者的真菌合并感染发生率。
我们的研究纳入了94例侵袭性真菌感染患者，这些患者要么患有COVID-19感染，要么已从COVID-19感染中康复。将疑似部位的组织样本用福尔马林固定，用于组织病理学检查，并根据需要用苏木精和伊红以及过碘酸希夫/戈莫里六胺银染色。
共收到94份临床怀疑为毛霉病的活检样本。其中，52份（55.3%）毛霉病检测呈阳性，42份（44.7%）呈阴性。在52例阳性病例中，46例（88.4%）为男性，6例（11.6%）为女性。病例数最多的年龄组为51 - 60岁（26.92%）。在52例阳性病例中，8例的氢氧化钾涂片真菌成分呈阳性，29例呈阴性。
糖尿病控制不佳和过度使用类固醇是加重COVID-19患者毛霉病发生率的两个主要因素。为了获得更好的患者预后，应尽早进行手术干预、组织病理学确诊以及快速且明智地进行静脉抗真菌治疗。
