Results from a national survey on COVID-19-associated mucormycosis in Germany: 13 patients from six tertiary hospitals.

Autor: Seidel D; Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany., Simon M; Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany., Sprute R; Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany., Lubnow M; Department of Anesthesiology and Intensive Care, University Hospital Regensburg, Regensburg, Germany., Evert K; Institute of Pathology, University of Regensburg, Regensburg, Germany., Speer C; Department of Nephrology, University of Heidelberg, Heidelberg, Germany., Seeßle J; Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany., Khatamzas E; Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany., Merle U; Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany., Behrens C; Department Medizinische Mikrobiologie und Technische Hygiene, Medizet, Städtisches Klinikum München GmbH, Munich, Germany., Blau IW; Department of Hematology, Oncology and Cancer Immunology, Charité University Medicine Berlin, Berlin, Germany., Enghard P; Department of Nephrology and Medical Intensive Care, Charité University Medicine Berlin, Berlin, Germany., Haas CS; Department of Internal Medicine, Nephrology and Intensive Care Medicine, University of Marburg, Marburg, Germany., Steinmann J; Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.; Institute of Medical Microbiology, University Hospital Essen, Essen, Germany., Kurzai O; National Reference Center for Invasive Fungal Infections, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knoell Institute, Jena, Germany.; Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany., Cornely OA; Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany.
Jazyk: angličtina
Zdroj: Mycoses [Mycoses] 2022 Jan; Vol. 65 (1), pp. 103-109. Date of Electronic Publication: 2021 Nov 16.
DOI: 10.1111/myc.13379
Abstrakt: Background: Most COVID-19-associated mucormycosis (CAM) cases are reported from India and neighbouring countries. Anecdotally cases from Europe have been presented.
Objective: To estimate the disease burden and describe the clinical presentation of CAM in Germany.
Methods: We identified cases through German mycology networks and scientific societies, and collected anonymised clinical information via FungiScope®.
Results: We identified 13 CAM cases from six tertiary referral hospitals diagnosed between March 2020 and June 2021. Twelve patients had severe or critical COVID-19, eleven were mechanically ventilated for a median of 8 days (range 1-27 days) before diagnosis of CAM. Eleven patients received systemic corticosteroids. Additional underlying medical conditions were reported for all but one patient, five were immunocompromised because of malignancy or organ transplantation, three were diabetic. Eleven patients developed pneumonia. Mortality was 53.8% with a median time from diagnosis of mucormycosis to death of 9 days (range 0-214 days) despite treatment with liposomal amphotericin B and/or isavuconazole in 10 of 13 cases. CAM prevalence amongst hospitalised COVID-19 patients overall (0.67% and 0.58% in two centres) and those admitted to the intensive care unit (ICU) (1.47%, 1.78% and 0.15% in three centres) was significantly higher compared to non-COVID-19 patients (P < .001 for respective comparisons).
Conclusion: COVID-19-associated mucormycosis is rare in Germany, mostly reported in patients with comorbidities and impaired immune system and severe COVID-19 treated in the ICU with high mortality compared to mainly rhino-orbito-cerebral CAM in patients with mild COVID-19 in India. Risk for CAM is higher in hospitalised COVID-19 patients than in other patients.
(© 2021 The Authors. Mycoses published by Wiley-VCH GmbH.)
Databáze: MEDLINE
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