Amani Kiana, Shahbazi Mojtaba, Behkar Atefeh, Farahmand Ghasem, Ghafouri Shima, Heydari Sanaz, Kaeedi Maryam, Magrouni Hana, Alizadeh Fatemeh, Ghabaee Mojdeh, Sarraf Payam, Tafakhori Abbas, Amirifard Hamed, Ranji-Burachaloo Sakineh, Mohammadianinejad Seyed Ehsan, Jameie Melika, Harirchian Mohammad Hossein
Neurology Ward, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Curr J Neurol. 2024 Jan 5;23(1):44-58. doi: 10.18502/cjn.v23i1.16432.
COVID-19 was associated with an increased number of patients with mucormycosis (MCR), followed by septic cavernous sinus thrombosis (SCST). We evaluated the association between anticoagulation (AC) and mortality/morbidity of COVID-19-associated MCR (CAM)-induced SCST. In this retrospective study, neurological sequelae, functional outcomes, and in-hospital mortality were compared between AC receivers and non-receivers. In addition, the association between AC and survivability was examined. Twenty-nine patients (17 male; mean age: 51.27 years) with CAM-induced SCST were included in the study. The median intervals between COVID-19 and MCR, and COVID-19 and SCST were 19 and 27 days, respectively. Among AC recipients, the interval between SCST and AC initiation was 18 days, with an AC duration of 37 days. Baseline and management-related characteristics were comparable between AC recipients and non-recipients (P > 0.050). AC receivers (n = 15) and non-receivers (n = 14) did not significantly differ in terms of the proportion of sequelae (6/15 vs. 5/14; P = 1.000), complete recovery (2/15 vs. 4/14; P = 0.687), and in-hospital mortality (3/15 vs. 3/14; P > 0.999). Nevertheless, AC recipients had a longer hospital stay (72.0 vs. 35.5; P = 0.016). AC-related characteristics (AC receiving, type, early initiation, and duration) were not significantly different between survivors and non-survivors, or between recovered and disabled patients. In our study, CAM-induced SCST in-hospital mortality/morbidity did not differ between AC receivers and non-receivers. AC characteristics were not different between survivors and non-survivors, or recovered and disabled patients. However, the small sample size may have limited the ability to detect significant differences, leading to inconclusive results.
新型冠状病毒肺炎（COVID-19）与毛霉菌病（MCR）患者数量增加有关，其次是感染性海绵窦血栓形成（SCST）。我们评估了抗凝治疗（AC）与COVID-19相关的MCR（CAM）所致SCST的死亡率/发病率之间的关联。在这项回顾性研究中，比较了接受抗凝治疗者和未接受抗凝治疗者的神经后遗症、功能结局和院内死亡率。此外，还研究了抗凝治疗与生存率之间的关联。本研究纳入了29例由CAM所致SCST的患者（17例男性；平均年龄：51.27岁）。COVID-19与MCR之间以及COVID-19与SCST之间的中位间隔分别为19天和27天。在接受抗凝治疗者中，SCST与开始抗凝治疗之间的间隔为18天，抗凝治疗持续时间为37天。接受抗凝治疗者和未接受抗凝治疗者在基线和管理相关特征方面具有可比性（P>0.050）。接受抗凝治疗者（n=15）和未接受抗凝治疗者（n=14）在后遗症比例（6/15对5/14；P=1.000）、完全康复（2/15对4/14；P=0.687）和院内死亡率（3/15对3/14；P>0.999）方面无显著差异。然而，接受抗凝治疗者的住院时间更长（72.0对35.5；P=0.016）。在幸存者与非幸存者之间，或康复者与残疾患者之间，与抗凝治疗相关的特征（接受抗凝治疗、类型、早期开始和持续时间）无显著差异。在我们的研究中，接受抗凝治疗者和未接受抗凝治疗者在CAM所致SCST的院内死亡率/发病率方面无差异。在幸存者与非幸存者之间，或康复者与残疾患者之间，抗凝治疗特征无差异。然而，样本量较小可能限制了检测显著差异的能力，导致结果不确定。
