Mucormycosis in patients with COVID-19 in Russia: the results of a prospective multi-center study

Mucormycosis in patients with COVID-19 in Russia: the results of a prospective multi-center study

We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation.The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we con...

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Main Authors: S. N. Khostelidi, V. A. Zaytsev, S. A. Vartanyan, N. A. Nikitin, G. N. Evtukh, M. N. Gilalov, G. V. Portnov, A. A. Zubareva, I. B. Baranova, T. S. Bogomolova, Yu. L. Avdeenko, O. V. Shadrivova, E. A. Desyatik, E. V. Shagdileeva, Yu. V. Borzova, Yu. A. Krivolapov, N. V. Vasilyeva, N. N. Klimko
Format: Article
Language:Russian
Published: Journal Infectology 2022-07-01
Series:Журнал инфектологии
Subjects:
covid-19
covid-19 associated mucormycosis
mucormycosis
rhino-orbital mucormycosis
rhizopus spp
Online Access:https://journal.niidi.ru/jofin/article/view/1360
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Summary:We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation.The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we conducted a case-control study. The control group included 60 adult patients with COVID-19 without mucormycosis. To analyze the clinical manifestations of COVID-M, we created a control group of hematological patients with mucormycosis examined in 2011–2020.In patients with COVID-19, the risk of developing mucormycosis was significantly increased with diabetes mellitus (OR=49) and overweight (OR=4,75), as well as with the use of high (≥100 mg per day for prednisolone) doses of glucocorticosteroids (OR= 4,762), especially ≥10 days (OR=25,4). The main localization of mucormycosis in patients with COVID-19 was the paranasal sinuses (95%) and the orbit (68%). Involvement of ≥2 organs was identified in 70% of patients. The main causative agents of mucormycosis were Rhizopus arrhizus (43%) and unidentified mucormycetes (36%).90-days overall survival of patients with mucormycosis and COVID-19 – 71%. The stay in the ICU (p=0,01), the use of mechanical ventilation (p=0,0481), the presence of CVC (p=0,049), CNS damage (p=0,016) and ≥ 2 organs (p=0,048) significantly worsened the prognosis of the disease. The best prognosis was in patients who received antifungal therapy (p=0,03875) and surgical treatment (p=0,046).
ISSN:2072-6732

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