COVID-19感染期间鼻-眶毛霉菌病的发生频率和结局:来自KPK三级保健中心的经验

Asif Mehmood Orakzai, Mohammad Idris, Muhammad Sharjeel, Irfan Aslam Khattak, Hidayataullah Mahsud, Zeeshan Hameed
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摘要

目的:了解KPK三级保健机构COVID-19感染期间鼻-眶毛霉菌病的发生频率和预后。研究设计:回顾性横断面研究设置和持续时间:2020年9月1日至2021年4月30日在白沙瓦Rehman医学研究所(8个月)。材料与方法:所有符合纳入标准的患者在知情同意并获得相关批准后,进行病史调查以确定危险因素、临床检查以确定感染程度、实验室和放射学检查以诊断和制定治疗方案。数据读数保存在Excel表格中,并使用SPSS v.25.0进行分析。结果:59例患者中,男性37例(62.71%),女性22例(37.29%)。大多数患者(42.37%)年龄在61 ~ 75岁之间。总共42例(71.18%)患者存活。40例(67.80%)患者眼眶受累,20例(33.89%)患者行除眼窝术。合并症中,糖尿病38例(64.40%),其次是高血压11例(18.64%),无合并症7例(11.86%)。结论:鼻眶毛霉菌病是新型冠状病毒肺炎患者常见的附加感染,且男性多于女性。大多数毛霉病患者要么是糖尿病患者,要么是正在接受COVID-19皮质类固醇治疗的患者。大多数患者最终会发生眼眶受累,多达三分之一的患者可能需要切除眼眶。然而,严格控制糖尿病,明智地使用类固醇,早期诊断和治疗毛霉病可能会提高总生存率。
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FREQUENCY AND OUTCOMES OF RHINO-ORBITAL MUCORMYCOSIS DURING COVID-19 INFECTION: EXPERIENCE FROM A TERTIARY CARE CENTER OF KPK
Aim: To study frequency and outcomes of rhino-orbital mucormycosis during COVID-19 infection in a tertiary care setup of KPK. Study Design: Retrospective cross-sectional study Settings and Duration: At Rehman Medical Institute, Peshawar from 1st September 2020 to 30th April 2021 (8 months). Materials and Methods: After taking informed consent and relevant approvals, all patients fulfilling the inclusion criteria underwent history taking to identify risk factors, clinical examination to find extent of infection and laboratory and radiological investigations to diagnose and find management plan. Data readings were save on Excel sheets and analyzed using SPSS v.25.0.   Results: Among 59 patients, 37 (62.71%) were male and 22 (37.29%) female. Most of the patients (42.37%) fell between age category of 61-75 years. Overall 42 (71.18%) patients survived. Orbital involvement was present in 40 (67.80%) patients and 20 (33.89%) had to underwent exenteration. Among comorbidities, diabetes was most prevalent in 38 (64.40%) followed by hypertension in 11 (18.64%) while 7 (11.86%) patients had no co-morbid state. Conclusion: Rhino-orbital mucormycosis is very common superadded infection in patients suffering from COVID-19 and involves males more than the females. Most of the mucormycosis patients are either diabetics or on corticosteroids therapy for COVID-19. Orbital involvement in mucormycosis eventually happens in majority of patients and up to one third patients may need exenteration. However, strict diabetes control, judicious use of steroids and early diagnosis and treatment of mucormycosis may increase overall survival rate.
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