1
|
Khavandegar A, Siami Z, Goudarzi S, Rasooli A, Ettehad Y. Investigation of microbial coinfection in 453 septic COVID-19 patients admitted to hospital; a retrospective study. Future Sci OA 2023; 9:FSO884. [PMID: 37752919 PMCID: PMC10518821 DOI: 10.2144/fsoa-2023-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/17/2023] [Indexed: 09/28/2023] Open
Abstract
Aim We evaluated the rate of COVID-19 microbial coinfection in an Iranian population. Methods In this single-center, retrospective observational study, we evaluated 453 septic COVID-19 patients for possible coinfection in an Iranian hospital. Results Overall, 211 (46.57%) cases died due to COVID-19 complications. Positive respiratory secretion and blood cultures were reported in 99 (21.9%) and 19 (4.2%) cases. Klebsiella species were the most commonly isolated microorganisms in respiratory (n = 50, 50.5%) and blood (n = 10, 52.6%) specimens. After adjustment for underlying disorders, positive respiratory microbial cultures significantly increase the odds of developing death, intubation, and ICU admission and negatively impact healthy discharge (P < 0.05). Conclusion Coinfections with bacteria and fungi independently contribute to poor outcomes in septic COVID-19 patients.
Collapse
Affiliation(s)
- Armin Khavandegar
- Sina Trauma & Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Siami
- Infectious Disease Department, Alborz University of Medical Sciences, Karaj, Iran
- Department of Infectious Diseases & Tropical Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sogand Goudarzi
- Department of Anesthesiology & Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Aziz Rasooli
- Department of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Ettehad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| |
Collapse
|
2
|
Gupta I, Baranwal P, Singh G, Gupta V. Mucormycosis, past and present: a comprehensive review. Future Microbiol 2023; 18:217-234. [PMID: 36970978 DOI: 10.2217/fmb-2022-0141] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Mucormycosis is an emerging opportunistic angioinvasive fungal infection. Predisposing factors such as diabetes, neutropenia, long-term corticosteroid therapy, solid organ transplantation and immunosuppression contribute to its occurrence. This disease was not of significant concern prior to the COVID-19 pandemic, but gained prominence due to infections in COVID-19 patients. Mucormycosis needs special attention and coordinated efforts of the scientific community and medical professionals to reduce morbidity and mortality. Here we present an overview of the epidemiology and prevalence of mucormycosis in the pre- and post-COVID-19 eras, the factors that contributed to the abrupt increase in COVID-19-associated mucormycosis (CAM), the actions taken by the regulatory agencies (including Code Mucor and CAM registry), the existing diagnostic tools and CAM management strategies.
Collapse
|
3
|
Balushi AA, Ajmi AA, Sinani QA, Menon V, Berieki ZA, Shezawi AA, Azri SA, Rashdi AA, Jardani AA, Baluki TA, Ghaithi SA, Reesi AA, Al-Za'abi AT, Al’ Balushi MA, Maqbali TA. COVID-19-Associated Mucormycosis: An Opportunistic Fungal Infection. A Case Series and Review. Int J Infect Dis 2022; 121:203-210. [PMID: 35533833 PMCID: PMC9075983 DOI: 10.1016/j.ijid.2022.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A surge in COVID-19-associated mucormycosis cases has been observed during the second wave of COVID-19 in summer of 2021. Most cases were reported from India. The Delta variant (B.1.617.2) was the most common variant circulating at that time. Mucormycosis is an opportunistic angioinvasive fungal infection with high morbidity and mortality. METHODS We present 10 cases of COVID-19-associated rhino-orbital and rhino-orbital-cerebral mucormycosis managed in a secondary hospital in Oman. RESULTS The median time for developing mucormycosis was two weeks after COVID-19 diagnosis. All patients were newly diagnosed or already known to have poorly controlled diabetes mellitus. Five patients received corticosteroid therapy for COVID-19. Three patients had severe COVID-19 and died of severe acute respiratory distress syndrome and septic shock. Another three patients died of advanced mucormycosis and cerebral involvement. Despite aggressive medical and surgical intervention, the mortality rate was 60% (6/10). CONCLUSION Mucormycosis is an aggressive opportunistic infection with high morbidity and mortality that requires prompt recognition and urgent intervention. Uncontrolled blood sugar, the use of corticosteroids, and immune dysfunction due to COVID-19 are all important risk factors for development of mucormycosis. Worse outcomes are associated with poor glycemic control despite aggressive medical and surgical interventions.
Collapse
Affiliation(s)
- Asma Al Balushi
- Infectious Diseases Unit, Internal Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman,Corresponding author: Asma Al Balushi: Address: Infectious Diseases Unit, Internal Medicine Department, Sultan Qaboos University Hospital, Muscat, Seeb, Alkhoudh, P. O. Box 35, Postal Code 123, Oman. Mobile number: (+968) 92319222
| | - Ahmed Al Ajmi
- Oral and Maxillofacial Surgery Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Qais Al Sinani
- Ear, Nose and Throat Surgical Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Varna Menon
- Histopathology Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Zainab Al Berieki
- Radiology Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Asma Al Shezawi
- Radiology Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Saleh Al Azri
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Azza Al Rashdi
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Amina Al Jardani
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Thuwaiba Al Baluki
- Internal Medicine Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Salem Al Ghaithi
- Internal Medicine Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | - Ali Al Reesi
- Internal Medicine Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| | | | | | - Talib Al Maqbali
- Ear, Nose and Throat Surgical Department, Sohar Hospital, Ministry of Health, Sohar, Oman
| |
Collapse
|
4
|
García-Carnero LC, Mora-Montes HM. Mucormycosis and COVID-19-Associated Mucormycosis: Insights of a Deadly but Neglected Mycosis. J Fungi (Basel) 2022; 8:jof8050445. [PMID: 35628701 PMCID: PMC9144279 DOI: 10.3390/jof8050445] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023] Open
Abstract
The ongoing COVID-19 pandemic has quickly become a health threat worldwide, with high mortality and morbidity among patients with comorbidities. This viral infection promotes the perfect setting in patients for the development of opportunistic infections, such as those caused by fungi. Mucormycosis, a rare but deadly fungal infection, has recently increased its incidence, especially in endemic areas, since the onset of the pandemic. COVID-19-associated mucormycosis is an important complication of the pandemic because it is a mycosis hard to diagnose and treat, causing concern among COVID-19-infected patients and even in the already recovered population. The risk factors for the development of mucormycosis in these patients are related to the damage caused by the SARS-CoV-2 itself, the patient’s overstimulated immune response, and the therapy used to treat COVID-19, causing alterations such as hyperglycemia, acidosis, endothelial and lung damage, and immunosuppression. In this review, the molecular aspects of mucormycosis and the main risk factors for the development of COVID-19-associated mucormycosis are explained to understand this virus–fungi–host interaction and highlight the importance of this neglected mycosis.
Collapse
Affiliation(s)
| | - Héctor M. Mora-Montes
- Correspondence: (L.C.G.-C.); (H.M.M.-M.); Tel.: +52-473-7320006 (ext. 8193) (H.M.M.-M.)
| |
Collapse
|
5
|
Singh A, Agrawal P, Kumar V. An analysis of proposed etiological factors for sudden spike in mucormycosis infection during COVID-19 pandemic at a tertiary hospital of North India. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2022. [DOI: 10.4103/injms.injms_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|