COVID-19 and mucormycosis superinfection: the perfect storm.

COVID-19 and mucormycosis superinfection: the perfect storm.
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DOI:
10.1007/s15010-021-01670-1
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发表时间:
2021-10
期刊:
影响因子:
7.5
通讯作者:
Dhama K
Dhama K
中科院分区:
医学3区
文献类型:
--
作者:
Al-Tawfiq JA;Alhumaid S;Alshukairi AN;Temsah MH;Barry M;Al Mutair A;Rabaan AA;Al-Omari A;Tirupathi R;AlQahtani M;AlBahrani S;Dhama K

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最近出现的冠状病毒病(COVID-19)疾病与真菌感染(如曲霉病和毛霉菌病)的报告有关,尤其是在接受类固醇治疗的重症患者中。印度近期COVID-19病例在第二波大流行期间激增,与COVID-19后侵袭性毛霉菌病的报告增加有关。有多份病例报告和病例系列描述了COVID-19中的毛霉菌病。在这篇综述中,我们纳入了最近报道的COVID-19患者中毛霉菌病的病例报告和病例系列,并描述了临床特征和结局。许多毛霉菌病报告来自印度,特别是在接受治疗和康复的COVID-19患者中。最常见的报告感染部位是鼻眶/鼻脑毛霉菌病。这些患者患有糖尿病,并接受皮质类固醇治疗以控制COVID-19的严重程度,导致此类病例的死亡率较高,并使大流行情况复杂化。严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)、糖皮质激素的使用和未控制的糖尿病三联体已明显导致血管侵袭性颌面部毛霉菌病的发病率显著增加。 此外,孢子和其他因素的存在也可能发挥作用。随着COVID-19大流行的持续和越来越多的重症患者感染SARS-CoV-2,重要的是要根据毛霉菌病的流行病学负担,糖尿病的患病率,COVID-19癌症患者的疾病严重程度和免疫调节剂的使用,包括皮质类固醇和免疫抑制剂的联合使用,移植
The recent emergence of the Coronavirus Disease (COVID-19) disease had been associated with reports of fungal infections such as aspergillosis and mucormycosis especially among critically ill patients treated with steroids. The recent surge in cases of COVID-19 in India during the second wave of the pandemic had been associated with increased reporting of invasive mucormycosis post COVID-19. There are multiple case reports and case series describing mucormycosis in COVID-19. In this review, we included most recent reported case reports and case-series of mucormycosis among patients with COVID-19 and describe the clinical features and outcome. Many  of the mucormycosis reports were eported from India, especially in COVID-19 patients who were treated and recovered patients. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis. Those patients  were diabetic and had corticosteroids therapy for controlling the severity of COVID-19, leading to a higher fatality in such cases and complicating the pandemic scenario. The triad of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), corticosteroid use and uncontrolled diabetes mellitus have been evident for significant increase in the incidence of angioinvasive maxillofacial mucormycosis.  In addition, the presence of spores and other factors might play a role as well. With the ongoing COVID-19 pandemic and increasing number of critically ill patients infected with SARS-CoV-2, it is important to develop a risk-based approach for patients at risk of mucormycosis based on the epidemiological burden of mucormycosis, prevalence of diabetes mellitus, COVID-19 disease severity and use of immune modulating agents including the combined use of corticosteroids and immunosuppressive agents in patients with cancer and transplants.
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入院的Covid-19患者中低皮质类固醇的临床特征和高层皮质类固醇的结果。
DOI: 10.2991/jegh.k.210521.001
发表时间: 2021-09
影响因子: 7.3
作者:
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发表时间: 2020-11
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