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毛霉菌病与新冠病毒肺炎的悲剧故事:印度中部一家三级医疗中心关于确定易感风险因素及结局的观察性研究

A Tragic Tale of Mucormycosis and COVID-19: An Observational Study to Identify Predisposing Risk Factors and Outcomes in a Tertiary Care Centre in Central India.

作者信息

Pandey Vandana, Kubre Jyotsna, Vatsalya Tripti, Ahirwar Kamal, Mehrotra Shikha

机构信息

Anaesthesiology, Gandhi Medical College, Bhopal, IND.

出版信息

Cureus. 2025 May 4;17(5):e83479. doi: 10.7759/cureus.83479. eCollection 2025 May.

Abstract

Objective The incidence of mucormycosis, an angioinvasive fungal infection, peaked in India affecting COVID-19 patients. The primary objective of our study was to identify the predisposing risk factors for its development in our country. The secondary objective of our study was to describe the factors affecting the anaesthetic management and the outcome of mucormycosis patients. Methods This was a retrospective observational hospital-based study. All the patients with post-COVID mucormycosis planned for surgical debridement in operation theatre were included. Patients with active COVID infection who tested positive by reverse transcriptase polymerase chain reaction, those with cerebral involvement and patients admitted for re-debridement surgeries were excluded from the study. Results About 86.6% of patients gave a prior history of COVID infection, while 21.1% did not have any prior history; 77% of patients were diagnosed cases of diabetes, 13% were newly diagnosed and 10% of patients were non-diabetics. About 62.2% of patients gave a positive history of hospitalization whereas 81.1% gave a positive history of use of steroids in some form or the other. Conclusions Among all the risk factors, history of COVID-19, presence of diabetes and use of steroids are the most important risk factors which contributed to the development of mucormycosis.

摘要

目的

毛霉菌病是一种侵袭血管的真菌感染,其发病率在印度达到峰值,且影响了新冠病毒疾病(COVID-19)患者。我们研究的主要目的是确定在我国其发病的诱发风险因素。我们研究的次要目的是描述影响麻醉管理的因素以及毛霉菌病患者的预后。方法:这是一项基于医院的回顾性观察研究。纳入所有计划在手术室进行手术清创的新冠后毛霉菌病患者。通过逆转录聚合酶链反应检测呈阳性的活动性新冠感染患者、有脑部受累的患者以及因再次清创手术入院的患者被排除在研究之外。结果:约86.6%的患者有新冠感染病史,而21.1%的患者没有任何既往病史;77%的患者被诊断为糖尿病,13%为新诊断出糖尿病,10%的患者无糖尿病。约62.2%的患者有住院史阳性,而81.1%的患者有以某种形式使用类固醇的阳性史。结论:在所有风险因素中,新冠病毒疾病病史、糖尿病的存在以及类固醇的使用是导致毛霉菌病发病的最重要风险因素。

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