Increased incidence of rhino-orbital mucormycosis in an educational therapeutic hospital during the COVID-19 pandemic in western Iran: An observational study.

Autor:	Avatef Fazeli M; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Rezaei L; Department of Ophthalmology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Javadirad E; Department of Pathology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Iranfar K; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Khosravi A; Department of Ophthalmology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Amini Saman J; Department of Anesthesiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Poursabbagh P; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Ghadami MR; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran., Parandin MM; Department of Ophthalmology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Dehghani A; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Ahmadi Jouybari T; Department of Interna, Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Mahdavian B; Department of Infectious Disease, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Eivazi N; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Rezaei S; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Rezaei A; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Emami B; Imam Khomeini and Mohamad Kermanshahi Clinical Research Development Unit, Kermanshah University of Medical Sciences, Kermanshah, Iran., Haqgou M; Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Bozorgomid A; Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran., Sayad B; Department of Infectious Disease, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.; Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Jazyk:	angličtina
Zdroj:	Mycoses [Mycoses] 2021 Nov; Vol. 64 (11), pp. 1366-1377. Date of Electronic Publication: 2021 Jul 31.
DOI:	10.1111/myc.13351
Abstrakt:	Background: COVID-19 patients, especially the patients requiring hospitalisation, have a high risk of several complications such as opportunistic bacterial and fungal infections. Mucormycosis is a rare and opportunistic fungal infection that mainly affects diabetic and immunocompromised patients. An increase has been observed in the number of rhino-orbital mucormycosis in patients with COVID-19 admitted to Imam Khomeini Hospital, Kermanshah, Iran, since October 2020. This is a report of the frequency, risk factors, clinical manifestations, treatment and prognosis of COVID-19 associated with mucormycosis infection. Methods: The medical records of COVID-19 patients with rhino-orbital mucormycosis who were diagnosed in an educational therapeutic hospital in Kermanshah, west of Iran were surveyed. Several parameters were analysed including demographic, clinical, therapeutic and laboratory characteristics. Results: Twelve patients with COVID-19-associated rhino-orbital mucormycosis were identified from 12 October to 18 November 2020. All cases reported as proven mucormycosis had a history of hospitalisation due to COVID-19. Comorbidities mainly included diabetes mellitus (83.33%) and hypertension (58.33%). Seventy-five per cent of patients received corticosteroids for COVID- 19 treatment. The sites of involvement were rhino-sino-orbital (83%) and rhino-sino (17%). Amphotericin B/liposomal amphotericin B alone or in combination with surgical debridement or orbital exenteration was used as the first-line therapy. The overall mortality rate was 66.7% (8/12). Conclusions: We found a high incidence of mucormycosis among COVID-19 patients. Diabetes mellitus and corticosteroid use were the dominant predisposing factor of mucormycosis. Mucormycosis is a life-threatening and opportunistic infection; therefore, physicians should know the signs and symptoms of the disease so that a timely diagnosis and therapy can be performed. (© 2021 Wiley-VCH GmbH.)
Databáze:	MEDLINE
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