Risk Factors of COVID-19 Associated Mucormycosis (CAM) in Iranian Patients: A Single-Center Retrospective Study.

Autor: Tavakolpour S; Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02215, USA., Irani S; Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Yekaninejad MS; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran., Alimardi M; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran., Hasibi M; Department of Internal Ward, Amiralam Hospital, Tehran University Medical Sciences, Tehran, Iran., Abdollahi H; Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran., Kazemi MA; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Lotfi M; Department of Pathology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Shahbazian H; Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02215, USA., Nazemian Yazdi NA; Department of Anesthesiology and Critical Care, School of Medicine, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Samimiardestani S; Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Firouzifar M; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Farahbakhsh F; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Mirzaee Goodarzi M; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Feiz F; Department of Internal Medicine, Division of Endocrinology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, 11457-65111, Iran., Salehinia F; Department of Internal Medicine, Division of Endocrinology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, 11457-65111, Iran. salehiniafarahnaz84@gmail.com.
Jazyk: angličtina
Zdroj: Mycopathologia [Mycopathologia] 2022 Dec; Vol. 187 (5-6), pp. 469-479. Date of Electronic Publication: 2022 Oct 06.
DOI: 10.1007/s11046-022-00670-5
Abstrakt: Background: COVID-19 associated mucormycosis (CAM) has been known as one of the most severe post-COVID morbidities.
Objectives: To describe CAM cases, identify possible risk factors, and report outcomes of patients.
Methods: This retrospective study was performed in Amir-Alam Hospital, Tehran, Iran between February 2020 and September 2021. Patients with mucormycosis who had an active or previous diagnosis of COVID-19 have been included.
Results: Of 94 patients with mucormycosis, 52 (33 men and 19 women; mean age: 57.0 ± 11.82 years) were identified with an active or history of COVID-19. Rhino-orbital, rhino maxillary, rhino-orbito cerebral subtypes of mucormycosis were detected in 6 (11.5%), 18(34.6%), and 28(53.8%) patients. As a control group, 130 (69 men and 61 women; mean age: 53.10 ± 14.49 years) random RT-PCR-confirmed COVID-19 patients without mucormycosis have been included. The mean interval between COVID-19 diagnosis and initial mucormycosis symptoms was 16.63 ± 8.4 days (range 0-51). Those in the CAM group had a significantly more severe course of COVID-19 (OR = 3.60, P-value < 0.01). Known history of previous diabetes mellitus (OR = 7.37, P-value < 0.01), smoking (OR = 4.55, P-value < 0.01), and history of receiving high-dose corticosteroid pulse therapy because of more severe COVID-19 (P-value = 0.022) were found as risk factors. New-onset post-COVID hyperglycemia was lower in the CAM group (46.2% vs. 63.8%; OR = 0.485, P-value = 0.028). After treatment of the CAM group, 41(78.8%) of patients recovered from mucormycosis. The mean ages of the expired patients in the CAM group were significantly higher than those who recovered from mucormycosis (66.18 ± 9.56 vs. 54.56 ± 11.22 years; P < 0.01); and COVID-19 disease was more severe (P = 0.046).
Conclusion: Either active or history of COVID-19 can cause an increase in the risk of mucormycosis development. Some of the most important risk factors are the medical history of diabetes mellitus, smoking, and high-dose corticosteroid therapy. CAM is important possible comorbidity related to COVID-19, which could make the post-COVID conditions more complicated. More research and studies with greater sample sizes among different ethnicities are needed to explore the association between COVID-19 and mucormycosis.
(© 2022. Crown.)
Databáze: MEDLINE
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