The hospitalization rate and clinical characteristics of mucormycosis prior and during COVID-19 pandemic: A single-center study.
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Estakhr Mehrdad, Ghotbi Zahra, Rostamihosseinkhani Mahtab, Hooshmandi Etrat, Janipour Masoud, Ostovan Vahid Reza, Fadakar Nima, Bazrafshan Hanieh, Bahrami Zahra, Rahimi-Jaberi Abbas, Poursadeghfard Maryam, Nazeri Masoumeh, Kouhi Pariya, Petramfar Peyman, Izadi Sadegh, Barzegar Zohreh, Nikzadeh Ehsan, Sasannia Sarvin, Arsang-Jang Shahram, Tabrizi Reza, Khademi Behzad, Kohandel-Shirazi Mahsa, Salehi Mohammad Saied, Ashjazadeh Nahid, Khademi Bijan, Ashraf Mohammad Javad, Eilami Owrang, Roudgari Amir, Moghaddami Mohsen, Zomorodian Kamiar, Badali Hamid, Borhani-Haghighi Afshin
Аннотация
METHODOLOGY: In this retrospective study, we compared the hospitalization rate of mucormycosis patients in Namazi hospital in Southern Iran for two periods of 40 months. We defined July 1st, 2018 to February 17th, 2020, as the pre-COVID-19 period and February 18th, 2020, to September 30th, 2021, as the COVID-19 period. In addition, a quadrupled group of hospitalized patients with age and sex-matched SARS-COV-2 infection without any sign of mucormycosis was selected as the control group for COVID-associated mucormycosis.
RESULT: In the total of 72 mucormycosis patients in the COVID period, 54 patients had a clinical history and a positive RT-PCR, which confirms the diagnosis of SARS-COV2 infection. The hospitalization rate of mucormycosis showed an increase of + 306% (95% CI: + 259%, + 353%) from a monthly average value of 0.26 (95% confidence interval (CI): 0.14, 0.38) in the pre-COVID period to 1.06 in the COVID period. The use of corticosteroids prior to the initiation of hospitalization (p ≤ 0.01), diabetes (DM) (p = 0.04), brain involvement (p = 0.03), orbit involvement (p = 0.04), and sphenoid sinus invasion (p ≤ 0.01) were more common in patients with mucormycosis during the COVID period.
CONCLUSIONS: In high-risk patients, especially diabetics, special care to avoid the development of mucormycosis must be taken into account in patients with SARS-COV-2 infection considered for treatment with corticosteroids.