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Evaluation and Comparison of Mucormycosis Patients' Features Undergoing Functional Endoscopic Sinus Surgery Prior to
Laleh Dehghanpisheh1, Mohammadhossein Eghbal1, Mehrdad Salari1
1Anesthesiology and Critical Care Research Center, Department of Anesthesiology and Critical Care, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Background:
Rhinocerebral mucormycosis is a serious invasive fungal infection that is one of the most aggressive and lethal of invasive mycoses. The coronavirus disease (COVID-19) has been linked to immune dysregulation, and patients with COVID-19 have been reported to be at risk for developing invasive fungal infections. This study is conducted to evaluate the concurrence of mucormycosis among COVID-19 patients.
Methods:
In this retrospective, cross-sectional study, hospital records of patients with mucormycosis, as well as COVID-19 admitted to Khalili Hospital, as the major referral center for functional endoscopic sinus surgery (FESS) in southern Iran, were collected. Demographic and clinical information was extracted and subsequently analyzed.
Results:
Among 59 mucormycosis patients undergoing FESS, 41 (69.5%) were during the COVID-19 pandemic, while 18 (30.5%) were during one year before the COVID-19 pandemic. The average age was 49.33 ± 20.52, and 64.4% had diabetes mellitus, while 62.7% had COVID-19. The most common presentation was periorbital edema (56.9%), followed by necrotic tissue (48.3%). Although the total number of cases increased during the COVID-19 period compared to the case before the pandemic, the overall pattern and features of the patients had no significant difference, except regarding a significant increase in the presentation of necrotic tissue and also the use of corticosteroids. Most cases developed mucormycosis two weeks after COVID-19. The overall mortality was 36.8%, which is not statistically associated with COVID-19.
Conclusion:
Even in the absence of comorbidities, physicians should be aware of the risk of secondary fungal infections in patients with COVID-19 who were treated with corticosteroids.
Insights
COVID-19 patients face increased risk of invasive fungal infections like mucormycosis, particularly when treated with corticosteroids. This study found more cases during the pandemic, with necrotic tissue and corticosteroid use significantly increasing.
Area of Science:
- Infectious Diseases
- Mycology
- Epidemiology
Background:
- Rhinocerebral mucormycosis is a severe, life-threatening invasive fungal infection.
- Coronavirus disease (COVID-19) is associated with immune dysregulation, increasing susceptibility to invasive fungal infections.
- Previous reports indicate a heightened risk of invasive fungal infections in COVID-19 patients.
Purpose of the Study:
- To evaluate the incidence and characteristics of mucormycosis in patients diagnosed with COVID-19.
- To compare the prevalence and clinical features of mucormycosis before and during the COVID-19 pandemic.
Main Methods:
- A retrospective, cross-sectional study analyzing hospital records of mucormycosis and COVID-19 patients.
- Data collected from Khalili Hospital, a major referral center for functional endoscopic sinus surgery (FESS) in southern Iran.
- Demographic and clinical information was extracted and analyzed.
Main Results:
- Out of 59 mucormycosis patients undergoing FESS, 41 (69.5%) occurred during the COVID-19 pandemic.
- The average age was 49.33 years; 64.4% had diabetes mellitus and 62.7% had COVID-19.
- Increased incidence of necrotic tissue and corticosteroid use were noted during the pandemic; mortality was 36.8% and not statistically linked to COVID-19.
Conclusions:
- Physicians must remain vigilant for secondary fungal infections in COVID-19 patients, even without comorbidities.
- Corticosteroid treatment in COVID-19 patients is a significant risk factor for invasive fungal infections like mucormycosis.
- Awareness and prompt diagnosis are crucial for managing mucormycosis in the context of the COVID-19 pandemic.
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