Risk Factors, Clinical Manifestations, and Outcomes of COVID-19-Associated Mucormycosis and Other Opportunistic Fungal Infections.
covid associated mucormycosis
covid-19
immunosuppression
mortality
mucormycosis
opportunistic fungal infections
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
accepted:
30
09
2023
medline:
2
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
epublish
Résumé
An epidemic of opportunistic fungal infections during the second wave of the coronavirus disease 2019 (COVID-19) pandemic badly affected India in 2021. Several unknown, unique factors played a role in its causation and survival outcomes, including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of this study was to analyse the probable underlying risk factors and to know immediate and late outcomes of opportunistic fungal infections in the unique setting of the SARS-CoV-2 pandemic. In this retrospective cohort study, clinical records of COVID-19-associated opportunistic fungal infections were reviewed for risk factors, clinical features, microbiological and pathological findings, and outcomes during a one-year follow-up at a tertiary care teaching hospital in Northern India. A total of 390 patients were admitted with symptoms and clinical signs consistent with the criteria for the diagnosis of COVID-19-associated mucormycosis (CAM). Diabetes mellitus was the most common comorbidity (74%). During the management of SARS-CoV-2, 192 (49%) patients received corticosteroids, 151 (39%) were on oxygen support, and 143 (37%) used at-home steam inhalation. Masks of any type were used by 236 (60.5%) patients, of whom most used cloth masks (n=147, 37.6%). Microbiologically, fungal growth was positive in 138 (35.3%) samples; of these, 74 (19%) had non-Mucorales fungal colonies. The fungal infection invaded structures beyond the paranasal sinuses in 60% of the cases. The overall mortality in this cohort after one-year follow-up was 40.25%. An alignment of several predisposing conditions precipitated an epidemic of opportunistic fungal infections during the COVID-19 pandemic that resulted in high mortality in affected patients.
Identifiants
pubmed: 37915866
doi: 10.7759/cureus.46289
pmc: PMC10616357
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e46289Informations de copyright
Copyright © 2023, Kumar et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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