Clinical characteristics, management, and outcomes of post COVID-19 mucormycosis in a private ENT hospital in Surat: a retrospective analysis

Shailee Mehta, Farida Wadia, Mithram Z. Wadia, Alok Karulkar
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Abstract

Background: Objectives of the study were to assess the age group affected, common presentation, extent of disease of mucormycosis and treatment modalities in post covid patients. Methods: All covid positive patients or recently recovered from covid with features of mucormycosis endoscopically and radiologically were included in this study. All patients that came in the outpatient department were screened using nasal endoscope and CT scans were performed. Patient’s clinical findings and endoscopic findings were correlated with the scans during the pandemic and decision to operate the cases was taken. It was a team approach by otorhinolaryngologist, ophthalmologist, endocrinologist, intensivist and nephrologist. Patients were followed up to 1 year.   Results: 65 patients that suggested of mucormycosis clinically, endoscopically, and radiologically were studied. It included 50 (76.9%) males and 15 (23.1%) females and histologically after operating, mucor was present in 44 cases (67.6) and 9 (13.8%) were aspergillosis. Conclusions: Post-COVID mucormycosis was reported after the second COVID wave in India especially after steroid therapies in diabetic patients. Thus, a timely, aggressive, team approach using Modified Denkers or open maxillectomy along with proper intravenous antifungals is the key to survival in such patients.
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苏拉特一家私立耳鼻喉科医院 COVID-19 后粘孢子菌病的临床特征、管理和结果:回顾性分析
背景:本研究的目的是评估粘孢子菌病患者的年龄组、常见表现、疾病程度和治疗方法:本研究的目的是评估粘孢子菌病的患病年龄组、常见表现、病变程度以及治疗方法:方法:所有内镜和放射学检查呈粘液瘤病特征的科维德阳性患者或近期从科维德康复的患者均纳入本研究。门诊部使用鼻内窥镜对所有患者进行筛查,并进行 CT 扫描。在大流行期间,将患者的临床表现和内窥镜检查结果与扫描结果进行比对,然后决定是否对病例进行手术。这是一个由耳鼻喉科医生、眼科医生、内分泌科医生、重症监护医生和肾脏科医生组成的团队。对患者进行了长达一年的随访。 结果研究了 65 名通过临床、内窥镜和放射学检查发现患有粘液瘤病的患者。手术后的组织学检查结果显示,44 例(67.6%)存在黏菌血症,9 例(13.8%)为曲霉菌病:结论:印度第二次 COVID 浪潮后,特别是糖尿病患者接受类固醇治疗后,出现了 COVID 后粘孢子菌病。因此,采用改良登革热手术或开放式上颌骨切除术以及适当的静脉注射抗真菌药物等及时、积极的团队治疗方法是此类患者存活的关键。
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