Singh Rajender, Mittal Garima, Kakati Barnali, Koul Nupur
Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND.
Cureus. 2024 Mar 30;16(3):e57295. doi: 10.7759/cureus.57295. eCollection 2024 Mar.
Background Fungal infections, especially mucormycosis, have remarkably surged during the coronavirus disease 2019 (COVID-19) era, especially during the second wave peak of the pandemic raising the concern of the clinicians for the admitted patients. Steroid therapy, diabetes, and other immunocompromised states are more commonly associated with COVID-19-associated mucormycosis (CAM). Aim and objective The aim of this study is to ascertain the prevalence of fungal infections amidst the second wave of the COVID-19 pandemic and discern the associated risk factors. Materials and methods During the second peak of COVID-19, samples were received in the microbiology laboratory from all clinically suspected mucormycosis patients. These samples underwent processing for potassium hydroxide (KOH) wet mount, fungal culture on Sabouraud's dextrose agar (SDA) medium, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) testing. All relevant clinical and associated risk factors were tabulated and analyzed. Results Among the 107 suspected cases of mucormycosis, 39 (36.4%) were confirmed positive for COVID-19 via RT-PCR, while 68 (63.6%) tested negative. Males exhibited a predominant infection rate, with the rhinocerebral system being the most commonly affected site. Significantly higher mortality rates were observed in COVID-19-associated mucormycosis (CAM) patients (33.4%) compared to those without COVID-19 (5.9%), with a notable p-value of 0.0005. CAM patients also demonstrated a higher frequency of ICU admissions (77%) compared to non-COVID-19-associated mucormycosis patients (21.4%), a statistically significant finding (p-value of 0.007). Additionally, immunocompromised states, diabetes, and the administration of oxygen therapy were identified as significant risk factors in CAM (p < 0.05). Notably, mucormycosis accounted for the majority of fungal isolates (48.27%) among COVID-19 patients. Conclusion Mucormycosis infection is more commonly seen in COVID-19-infected patients as compared to non-COVID-19 patients, especially with comorbidities such as diabetes mellitus, steroid usage, and other immunocompromised states.
背景 真菌感染，尤其是毛霉病，在2019冠状病毒病（COVID-19）大流行期间显著激增，特别是在疫情的第二波高峰期，这引起了临床医生对住院患者的关注。类固醇治疗、糖尿病和其他免疫功能低下状态更常与COVID-19相关毛霉病（CAM）相关。目的 本研究的目的是确定COVID-19大流行第二波期间真菌感染的患病率，并识别相关危险因素。材料和方法 在COVID-19的第二个高峰期，微生物实验室接收了所有临床疑似毛霉病患者的样本。这些样本进行了氢氧化钾（KOH）湿片检查、在沙氏葡萄糖琼脂（SDA）培养基上进行真菌培养以及COVID-19逆转录聚合酶链反应（RT-PCR）检测。所有相关临床和相关危险因素都被列表并分析。结果 在107例疑似毛霉病病例中，39例（36.4%）通过RT-PCR确诊为COVID-19阳性，而68例（63.6%）检测为阴性。男性感染率占主导，鼻脑系统是最常受影响的部位。与未感染COVID-19的患者（5.9%）相比，COVID-19相关毛霉病（CAM）患者的死亡率显著更高（33.4%），p值为0.0005，具有显著意义。与非COVID-19相关毛霉病患者（21.4%）相比，CAM患者入住重症监护病房（ICU）的频率也更高（77%），这是一个具有统计学意义的发现（p值为0.007）。此外，免疫功能低下状态、糖尿病和氧疗被确定为CAM的重要危险因素（p < 0.05）。值得注意的是，在COVID-19患者中，毛霉病占真菌分离株的大多数（48.27%）。结论 与未感染COVID-19的患者相比
