A Comparative Study of Acute Invasive Fungal Sinusitis During the First and Second Waves of the COVID-19 Pandemic.

Autor: Kurien R; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Varghese L; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Cherian LM; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Inja RR; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Thampi M; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Chowdhary S; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Bright RR; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Abraham L; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Panicker R; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Rajendran N; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India., Ganesan P; Department of Emergency Medicine, Christian Medical College, Vellore, 632004 India., Sahu S; Department of Radiodiagnosis, Christian Medical College, Vellore, 632004 India., Irodi A; Department of Radiodiagnosis, Christian Medical College, Vellore, 632004 India., Manesh A; Department of Infectious Diseases, Christian Medical College, Vellore, 632004 India., Peter J; Department of Ophthalmology, Christian Medical College, Vellore, 632004 India., Michael JS; Department of Microbiology, Christian Medical College, Vellore, 632004 India., Thomas M; Department of Pathology, Christian Medical College, Vellore, 632004 India., Karuppusami R; Department of Biostatistics, Christian Medical College, Vellore, 632002 India., Varghese GM; Department of Infectious Diseases, Christian Medical College, Vellore, 632004 India., Rupa V; Department of Otorhinolaryngology, Christian Medical College, Vellore, 632004 Tamilnadu India.
Jazyk: angličtina
Zdroj: Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India [Indian J Otolaryngol Head Neck Surg] 2024 Feb; Vol. 76 (1), pp. 611-619. Date of Electronic Publication: 2023 Sep 16.
DOI: 10.1007/s12070-023-04226-x
Abstrakt: We aimed to compare the demography, clinical profile, histopathology, fungal culture, radiology, surgery performed, medical therapy and outcomes of patients with acute invasive fungal sinusitis seen during the first and second waves of the COVID-19 pandemic by retrospectively reviewing their case records. Of 238 patients, 43(18.1%) presented during the first wave and 195(81.9%) during the second wave. Patients seen during the first wave were older (p = 0.04) and more likely to have visual impairment (p = 0.004), frozen eye (p = 0.012), altered sensorium (p = 0.007) and stage 3 disease (p = 0.03). Those seen during the second wave were more often COVID-19 positive and had newly diagnosed diabetes mellitus (p = 0.04)and stage 1 disease (p = 0.03). Most patients had a positive culture for Rhizopus species during both waves. Histopathology showed broad aseptate hyphae in all patients but angioinvasion was seen more often during the first wave (p = 0.04). The majority of patients were treated with endoscopic+/- open debridement followed by intravenous amphotericin B and oral posaconazole. While the overall survival rate was similar (first wave 65.1%; second wave 79%; p = 0.106), mortality after discharge was greater during the first wave (11.6% vs 1.5%; p = 0.001). Mortality was higher in patients with stage 3 disease (p = 0.003). Significant differences in clinical presentation, histopathology, radiological stage of disease and post-discharge survival were noted between the two waves of the COVID-19 pandemic, the causes for which were multi-factorial.
Competing Interests: Conflict of interestThere is no conflict of interest for any of the authors listed above.
(© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
Databáze: MEDLINE
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