Sistema de Salut de Catalunya
Institut Català de la Salut
[Almyroudi MP] Department of Emergency Medicine, University Hospital Attikon, Medical School, National and Kapodistrian University of Athens, Athens, Greece. [Akinosoglou K] Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, School of Medicine University of Patras, Rio, Greece. [Rello J] Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Clinical Research, CHU Nîmes, Nîmes, France. [Blot S] Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium. UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia. [Dimopoulos G] 3rd Department of Critical Care, EVGENIDIO Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Vall d'Hebron Barcelona Hospital Campus
2023-01-18T13:47:20Z
2023-01-18T13:47:20Z
2022-12-08
SARS-CoV-2; Diabetes mellitus; Invasive fungal infections
SARS-CoV-2; Diabetes mellitus; Infecciones fúngicas invasivas
SARS-CoV-2; Diabetis mellitus; Infeccions fúngiques invasives
A mucormycosis surge was reported during the COVID-19 pandemic in India. A literature search until 14 July 2022, with the aim of updating COVID-19-associated mucormycosis (CAM), identified 663 studies and 88 met inclusion criteria (8727 patients). India reported 8388 patients, Egypt 208 and Europe 40. Rhino-orbito-cerebral mucormycosis (ROCM) was identified among 8082 (98.3%) patients, followed by 98 (1.2%) with pulmonary. In India, 82.6% of patients had diabetes mellitus, with 82% receiving corticosteroids. In Europe, 75% presented pulmonary CAM, 32.5% had diabetes and 40% were immunocompromised. CAM was identified at a median of 17.4 days (IQR 7.5 days) post COVID-19 diagnosis, and PCR was performed in five studies. Rhino-orbital invasion is clinically obvious, while cerebral involvement presents with cavernous sinus thrombosis, meningitis and cerebrovascular disease. Symptoms of pulmonary CAM usually overlap with severe COVID-19 pneumonia. High-dose liposomal Amphotericin B (and early surgical debridement in ROCM) are the mainstay of therapy. The median mortality rate was estimated to be 21.4% (IQR 31.9%), increased by the presence of pulmonary (80% (IQR 50%) or cerebral involvement (50% (IQR 63.9%). In summary, different CAM clinical phenotypes need to be distinguished, influenced by geographical presentation. Opportunities exist for diagnosis and therapy optimization, based on earlier high-dose antifungal therapy, early source control, strict glycemic control and restriction of steroids to COVID-19 patients with oxygen requirements.
Article
Published version
English
COVID-19 (Malaltia) - Complicacions; Medicaments antifúngics - Ús terapèutic; Micosi - Tractament; DISEASES::Bacterial Infections and Mycoses::Mycoses::Zygomycosis::Mucormycosis; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections; Other subheadings::Other subheadings::Other subheadings::/complications; CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antifungal Agents; Other subheadings::Other subheadings::/therapeutic use; ENFERMEDADES::infecciones bacterianas y micosis::micosis::zigomicosis::mucormicosis; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus; Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones; COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antifúngicos; Otros calificadores::Otros calificadores::/uso terapéutico
MDPI
Diagnostics;12(12)
https://doi.org/10.3390/diagnostics12123092
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - VHIR [1655]
