COVID-19后毛霉菌病病例的临床病理特征:来自三级护理中心的报告。

National Journal of Maxillofacial Surgery Pub Date : 2023-05-01 Epub Date: 2023-07-13 DOI:10.4103/njms.njms_482_21
Nupur Kaushik, Deepa Rani, Pooja Agarwal, Harendra Kumar, Lalit Kumar, Akhil Pratap Singh
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摘要

简介:毛霉菌病是一种致命的真菌感染,它很罕见,但通常影响免疫功能低下的患者。2019冠状病毒病(新冠肺炎)患者因血液系统恶性肿瘤和糖尿病(DM)等共病而免疫功能低下,以及接受类固醇治疗等免疫抑制治疗的患者是毛霉菌病感染的重要宿主。目的:本研究旨在研究COVID-19后患者毛霉菌病的临床病理相关性。材料和方法:该研究是一项回顾性研究,于2021年4月至2021年7月在印度北方邦阿格拉Sarojini Naidu医学院病理学系进行,历时四个月,临床诊断的毛霉菌病病例包括在本研究中。对临床细节、组织学切片和切片进行了回顾,并对数据进行了分析。从块中取三到四微米的切片,用苏木精和伊红染色,并为每种情况再制作两张载玻片,用于碘酸Schiff(PAS)和Grocott-methenamine银(GMS)染色。结果:在这项研究中,最大的病例发生在生命的第五个十年以上。男性比女性更容易受到影响,男女比例为2.09:1。在65例病例中,46例(70.77%)毛霉菌病阳性,19例(29.23%)组织病理学检查和特殊染色PAS和GMS阴性。新冠肺炎治疗期间,类固醇治疗的毛霉菌阳性病例与氧气供应之间存在显著相关性,P值分别为0.001和0.027。结论:对于血糖控制改变的新冠肺炎患者,接受类固醇治疗和氧气供应对毛霉菌病的发展构成重大威胁。
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Clinicopathological profile of post-COVID-19 mucormycosis cases: A report from a tertiary care center.

Introduction: Mucormycosis is a fatal fungal infection, which is rare but commonly affects immunocompromised patients. Coronavirus disease 2019 (COVID-19) patients who were immunocompromised, due to comorbid conditions, such as hematological malignancy and diabetes mellitus (DM), and patients on immunosuppressive therapy such as steroid therapy were the important host for mucormycosis infection.

Aim: This study aimed to study the clinicopathological correlation of mucormycosis in post-COVID-19 patients.

Material and methods: The study was a retrospective study conducted in the Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over four months from April 2021 to July 2021, and clinically diagnosed mucormycosis cases were included in this study. Clinical details, histology slides, and blocks were reviewed, and the data were analyzed. Three- to four-micrometer sections were taken from the blocks and stained with hematoxylin and eosin, and two more slides were made for each case for periodic acid-Schiff (PAS) and Grocott methenamine silver (GMS) staining.

Result: In this study, the maximum cases were above the fifth decade of life. Males were more commonly affected than females with a male-to-female ratio of 2.09:1. Of the total of 65 cases, 46 (70.77%) cases were positive for mucormycosis and 19 (29.23%) cases were negative on histopathological examination and special stain PAS and GMS. A significant correlation was found between mucormycosis-positive cases on steroid therapy and oxygen supply during the treatment for COVID-19 with P- values of 0.001 and 0.027, respectively.

Conclusion: For COVID-19 patients with altered glycemic control, receiving steroid therapy and oxygen supply poses a significant threat to the development of mucormycosis.

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