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新冠疫情前后毛霉菌病的住院率和临床特征:一项单中心研究。

The hospitalization rate and clinical characteristics of mucormycosis prior and during COVID-19 pandemic: A single-center study.

机构信息

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Otorhinolaryngology-Head and Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Infect Dev Ctries. 2023 Jun 30;17(6):791-799. doi: 10.3855/jidc.17371.

Abstract

INTRODUCTION

There have been some reports of the association between SARS-CoV-2 infection and mucormycosis. This study aims to compare the hospitalization rates and clinical characteristics of mucormycosis before and during the COVID-19 pandemic.

METHODOLOGY

In this retrospective study, we compared the hospitalization rate of mucormycosis patients in Namazi hospital in Southern Iran for two periods of 40 months. We defined July 1st, 2018 to February 17th, 2020, as the pre-COVID-19 period and February 18th, 2020, to September 30th, 2021, as the COVID-19 period. In addition, a quadrupled group of hospitalized patients with age and sex-matched SARS-COV-2 infection without any sign of mucormycosis was selected as the control group for COVID-associated mucormycosis.

RESULT

In the total of 72 mucormycosis patients in the COVID period, 54 patients had a clinical history and a positive RT-PCR, which confirms the diagnosis of SARS-COV2 infection. The hospitalization rate of mucormycosis showed an increase of + 306% (95% CI: + 259%, + 353%) from a monthly average value of 0.26 (95% confidence interval (CI): 0.14, 0.38) in the pre-COVID period to 1.06 in the COVID period. The use of corticosteroids prior to the initiation of hospitalization (p ≤ 0.01), diabetes (DM) (p = 0.04), brain involvement (p = 0.03), orbit involvement (p = 0.04), and sphenoid sinus invasion (p ≤ 0.01) were more common in patients with mucormycosis during the COVID period.

CONCLUSIONS

In high-risk patients, especially diabetics, special care to avoid the development of mucormycosis must be taken into account in patients with SARS-COV-2 infection considered for treatment with corticosteroids.

摘要

简介

有一些关于 SARS-CoV-2 感染和毛霉菌病之间关联的报告。本研究旨在比较 COVID-19 大流行前后毛霉菌病的住院率和临床特征。

方法

在这项回顾性研究中,我们比较了伊朗南部纳马齐医院两个 40 个月期间的毛霉菌病患者住院率。我们将 2018 年 7 月 1 日至 2020 年 2 月 17 日定义为 COVID-19 前时期,将 2020 年 2 月 18 日至 2021 年 9 月 30 日定义为 COVID-19 时期。此外,选择了一组年龄和性别匹配的 COVID-19 感染但没有任何毛霉菌病迹象的住院患者作为 COVID 相关毛霉菌病的对照组,数量是毛霉菌病患者的四倍。

结果

在 COVID 时期的总共 72 例毛霉菌病患者中,54 例有临床病史和 RT-PCR 阳性,证实了 SARS-COV2 感染的诊断。毛霉菌病的住院率从 COVID 前时期每月平均 0.26(95%CI:0.14,0.38)增加到 COVID 时期的 1.06,增加了 +306%(95%CI:+259%,+353%)。在 COVID 时期住院前使用皮质类固醇(p ≤ 0.01)、糖尿病(DM)(p = 0.04)、脑受累(p = 0.03)、眼眶受累(p = 0.04)和蝶窦侵犯(p ≤ 0.01)在 COVID 时期的毛霉菌病患者中更为常见。

结论

在高危患者中,特别是糖尿病患者中,对于考虑用皮质类固醇治疗的 SARS-COV-2 感染患者,必须特别注意避免毛霉菌病的发生。

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