Risk factors, mortality, and predictors of survival in COVID-19-associated pulmonary mucormycosis: a multicentre retrospective study from India.

Autor:	Muthu V; Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Agarwal R; Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: agarwal.ritesh@outlook.in., Rudramurthy SM; Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Thangaraju D; Department of Microbiology, Kovai Medical Center and Hospital, Coimbatore, India., Shevkani MR; Department of Infectious Diseases, Avron Hospitals, Ahmedabad, India., Patel AK; Department of Infectious Diseases, Sterling Hospital, Ahmedabad, India., Shastri PS; Critical Care, Sir Gangaram Hospital, New Delhi, India., Tayade A; Department of Infectious Diseases, Kingsway Hospital, Nagpur, Maharashtra, India., Bhandari S; Department of Internal Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India., Gella V; Department of Pulmonary Medicine, Asian Institute of Gastroenterology, Hyderabad, Telangana, India., Savio J; Department of Microbiology, St. John's Medical College and Hospital, Bangalore, Karnataka, India., Madan S; Department of Infectious Diseases, Care Institute of Medical Sciences, Ahmedabad, Gujarat, India., Hallur V; Department of Microbiology, All India Institute of Medical Science Bhubaneswar, Odisha, India., Maturu VN; Department of Pulmonary Medicine, Yashoda Hospitals, Somajiguda, Hyderabad, India., Srinivasan A; Department of Pulmonary Medicine, Royal Care Hospital, Coimbatore, India., Sethuraman N; Department of Microbiology, Apollo Hospitals, Chennai, India., Singh Sibia RP; Department of Internal Medicine, Government Medical College, Patiala, Punjab, India., Pujari S; Department of HIV Medicine and Infectious Diseases, Poona Hospital and Research Centre, Pune, Maharashtra, India., Mehta R; Department of Pulmonary Medicine, Apollo Hospitals, Bengaluru, Karnataka, India., Singhal T; Department of Infectious Diseases, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India., Saxena P; Department of Pulmonary Medicine, Army Hospital (Research and Referral), New Delhi, India., Gupta V; Department of Microbiology, Government Medical College, Chandigarh, India., Nagvekar V; Department of Infectious Diseases, Global Hospital, Mumbai, India., Prayag P; Department of Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, India., Patel D; Department of Pulmonary Medicine, City Clinic and Bhailal Amin General Hospital, Vadodara, Gujarat, India., Xess I; Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India., Savaj P; Department of Infectious Diseases, Institute of Infectious Disease and Critical Care Hospital, Surat, Gujarat, India., Sehgal IS; Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Panda N; Department of Otorhinolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Rajagopal GD; Department of Microbiology, Kovai Medical Center and Hospital, Coimbatore, India., Parwani RS; Clinical Pharmacist, Avron Hospital, Ahmedabad, India., Patel K; Department of Microbiology and Infection Prevention & Control, Sterling Hospital, Ahmedabad, India., Deshmukh A; Department of Microbiology, Kingsway Hospital, Nagpur, Maharashtra, India., Vyas A; Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India., Gandra RR; Department of Pulmonary Medicine, Asian Institute of Gastroenterology, Hyderabad, Telangana, India., Sistla SK; Department of Otorhinolaryngology, Asian Institute of Gastroenterology, Hyderabad, Telengana, India., Padaki PA; Department of Microbiology, St. John's Medical College and Hospital, Bangalore, Karnataka, India., Ramar D; Clinical Associate, Department of Research, Care Institute of Medical Sciences, Ahmedabad, Gujarat, India., Sarkar S; Department of Otorhinolaryngology, All India Institute of Medical Science, Bhubaneswar, Odisha, India., Rachagulla B; Department of Pulmonary Medicine, Yashoda Hospitals, Somajiguda, Hyderabad, India., Vallandaramam P; Department of Pulmonary Medicine, Royal Care Hospital, Coimbatore, India., Premachandran KP; Department of Infectious Disease, Apollo Hospitals, Chennai, India., Pawar S; Department of Internal Medicine, Government Medical College, Patiala, Punjab, India., Gugale P; Department of HIV Medicine and Infectious Diseases, Poona Hospital and Research Centre, Pune, Maharashtra, India., Hosamani P; Department of Otorhinolaryngology, Apollo Hospitals, Bengaluru, Karnataka, India., Dutt SN; Department of Otorhinolaryngology, Apollo Hospitals, Bengaluru, Karnataka, India., Nair S; Department of Otorhinolaryngology, Apollo Hospitals, Bengaluru, Karnataka, India., Kalpakkam H; Department of Pulmonary Medicine, Apollo Hospitals, Bengaluru, Karnataka, India., Badhwar S; Department of Otorhinolaryngology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India., Kompella KK; Department of Internal Medicine and Infectious Diseases, Army Hospital (Research and Referral), New Delhi, India., Singla N; Department of Microbiology, Government Medical College, Chandigarh, India., Navlakhe M; Department of Otorhinolaryngology, Global Hospital, Mumbai, India., Prayag A; Department of Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, India., Singh G; Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India., Dhakecha P; Clinical Associate, Department of Research, Institute of Infectious Disease and Critical Care Hospital, Surat, Gujarat, India., Chakrabarti A; Director, Doodhadhari Burfani Hospital, Haridwar, Uttarakhand, India.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2024 Mar; Vol. 30 (3), pp. 368-374. Date of Electronic Publication: 2023 Dec 09.
DOI:	10.1016/j.cmi.2023.12.006
Abstrakt:	Objectives: To compare COVID-19-associated pulmonary mucormycosis (CAPM) with COVID-19-associated rhino-orbital mucormycosis (CAROM), ascertain factors associated with CAPM among patients with COVID-19, and identify factors associated with 12-week mortality in CAPM. Methods: We performed a retrospective multicentre cohort study. All study participants had COVID-19. We enrolled CAPM, CAROM, and COVID-19 subjects without mucormycosis (controls; age-matched). We collected information on demography, predisposing factors, and details of COVID-19 illness. Univariable analysis was used to compare CAPM and CAROM. We used multivariable logistic regression to evaluate factors associated with CAPM (with hypoxemia during COVID-19 as the primary exposure) and at 12-week mortality. Results: We included 1724 cases (CAPM [n = 122], CAROM [n = 1602]) and 3911 controls. Male sex, renal transplantation, multimorbidity, neutrophil-lymphocyte ratio, intensive care admission, and cumulative glucocorticoid dose for COVID-19 were significantly higher in CAPM than in CAROM. On multivariable analysis, COVID-19-related hypoxemia (aOR, 2.384; 95% CI, 1.209-4.700), male sex, rural residence, diabetes mellitus, serum C-reactive protein, glucocorticoid, and zinc use during COVID-19 were independently associated with CAPM. CAPM reported a higher 12-week mortality than CAROM (56 of the 107 [52.3%] vs. 413 of the 1356 [30.5%]; p = 0.0001). Hypoxemia during COVID-19 (aOR [95% CI], 3.70 [1.34-10.25]) and Aspergillus co-infection (aOR [95% CI], 5.40 [1.23-23.64]) were independently associated with mortality in CAPM, whereas surgery was associated with better survival. Discussion: CAPM is a distinct entity with a higher mortality than CAROM. Hypoxemia during COVID-19 illness is associated with CAPM. COVID-19 hypoxemia and Aspergillus co-infection were associated with higher mortality in CAPM. (Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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