Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt
Introduction: The present study aimed to explore the epidemiologic threats and factors associated with the coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) epidemic that emerged in Egypt during the second COVID-19 wave. The study also aimed to explore the diagnostic features and th...
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The Journal of Infection in Developing Countries
2024-12-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/19897 |
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| author | Safaa Elserougy Muhammad Abdel-Ghaffar Eman Medhat Ahmed Heiba Weam Shaheen Elham Mostafa Hala Mahfouz Samah Abdel-Hafez Mohammad S Mahfouz Shimaa Afify Omnia Ali Enass El-Sayed Ahmed M Mostafa Ahmed M Salah Anwar Elbatawy Hanan M Elghoneimy Amr A Elshafey Ahmed Abou-ElFotouh Tareq Abdul-Ghani Fatma I Ibrahim Sarah M Samy Manal S Elhussini |
| author_facet | Safaa Elserougy Muhammad Abdel-Ghaffar Eman Medhat Ahmed Heiba Weam Shaheen Elham Mostafa Hala Mahfouz Samah Abdel-Hafez Mohammad S Mahfouz Shimaa Afify Omnia Ali Enass El-Sayed Ahmed M Mostafa Ahmed M Salah Anwar Elbatawy Hanan M Elghoneimy Amr A Elshafey Ahmed Abou-ElFotouh Tareq Abdul-Ghani Fatma I Ibrahim Sarah M Samy Manal S Elhussini |
| author_sort | Safaa Elserougy |
| collection | DOAJ |
| description |
Introduction: The present study aimed to explore the epidemiologic threats and factors associated with the coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) epidemic that emerged in Egypt during the second COVID-19 wave. The study also aimed to explore the diagnostic features and the role of surgical interventions of CAM on the outcome of the disease in a central referral hospital.
Methodology: The study included 64 CAM patients from a referral hospital for CAM and a similar number of matched controls from COVID-19 patients who did not develop CAM.
Results: The most frequent factors among CAM patients were the use of corticosteroids, older age, and diabetes. CAM patients presented with facial pain (98.4%), black coloring on nasal endoscopy examination (87.5%), orbital invasion (70.3%), and loss of vision (68.8%). Despite treatment, CAM led to the death of 30 patients and 34 patients survived until the end of the study. CAM patients with death outcomes had orbital invasion, disturbed consciousness level, referral to intensive care units, and invasive mechanical ventilation. The patients who survived received more surgical interventions than dead patients, including functional endoscopic sinus surgery (FESS) and maxillofacial surgery.
Conclusions: CAM treatment requires complex, time-consuming, and expensive diagnostic approaches. Therefore, preventative measures should focus on early source control, strict glycemic control, and limiting steroids to COVID-19 patients especially older patients (> 40 years). Early antifungal treatment and surgical techniques such as FESS and necrotic tissue debridement were associated with better prognosis, indicating the efficiency of multidisciplinary medical and surgical teams.
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| format | Article |
| id | doaj-art-2475cc63d1df40329a99affa56f2c1db |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-2475cc63d1df40329a99affa56f2c1db2025-08-20T02:27:22ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-12-011812.110.3855/jidc.19897Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in EgyptSafaa Elserougy0Muhammad Abdel-Ghaffar1Eman Medhat2Ahmed Heiba3Weam Shaheen4Elham Mostafa5Hala Mahfouz6Samah Abdel-Hafez7Mohammad S Mahfouz8Shimaa Afify9Omnia Ali10Enass El-Sayed11Ahmed M Mostafa12Ahmed M Salah13Anwar Elbatawy14Hanan M Elghoneimy15Amr A Elshafey16Ahmed Abou-ElFotouh17Tareq Abdul-Ghani18Fatma I Ibrahim19Sarah M Samy20Manal S Elhussini21Environmental and Occupational Medicine Dpt., National Research Centre, Cairo, EgyptGastroenterology and Infectious Diseases Dpt., Ahmed Maher Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, EgyptTropical Medicine Dpt., Kasr El-Aini Hospital, Cairo University, Cairo, EgyptGastroenterology and Infectious Diseases Dpt., Ahmed Maher Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, EgyptEnvironmental and Occupational Medicine Dpt., National Research Centre, Cairo, EgyptEnvironmental and Occupational Medicine Dpt., National Research Centre, Cairo, EgyptInternal Medicine Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, EgyptGastroenterology and Infectious Diseases Dpt., Ahmed Maher Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, EgyptGastroenterology and Infectious Diseases Dpt., Ahmed Maher Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, EgyptGastroenterology Dpt., National Hepatology and Tropical Medicine Research Institute, GOTHI, Cairo, EgyptClinical and Chemical Pathology Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, EgyptNephrology Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, EgyptOtorhinolaryngology, Hearing and Speech Institute, GOTHI, Cairo, EgyptOral and Maxillofacial Surgery Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, EgyptOtorhinolaryngology, Hearing and Speech Institute, GOTHI, Cairo, EgyptMemorial Institute for Ophthalmic Research, GOTHI, Cairo, EgyptMemorial Institute for Ophthalmic Research, GOTHI, Cairo, EgyptMemorial Institute for Ophthalmic Research, GOTHI, Cairo, EgyptNeurosurgery Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, EgyptClinical Pharmacy Dpt., AL-Ahrar Teaching Hospital, GOTHI, Cairo, EgyptClinical Pharmacy, Ahmed Maher Teaching Hospital, GOTHI, Cairo, EgyptChest Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, Egypt Introduction: The present study aimed to explore the epidemiologic threats and factors associated with the coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) epidemic that emerged in Egypt during the second COVID-19 wave. The study also aimed to explore the diagnostic features and the role of surgical interventions of CAM on the outcome of the disease in a central referral hospital. Methodology: The study included 64 CAM patients from a referral hospital for CAM and a similar number of matched controls from COVID-19 patients who did not develop CAM. Results: The most frequent factors among CAM patients were the use of corticosteroids, older age, and diabetes. CAM patients presented with facial pain (98.4%), black coloring on nasal endoscopy examination (87.5%), orbital invasion (70.3%), and loss of vision (68.8%). Despite treatment, CAM led to the death of 30 patients and 34 patients survived until the end of the study. CAM patients with death outcomes had orbital invasion, disturbed consciousness level, referral to intensive care units, and invasive mechanical ventilation. The patients who survived received more surgical interventions than dead patients, including functional endoscopic sinus surgery (FESS) and maxillofacial surgery. Conclusions: CAM treatment requires complex, time-consuming, and expensive diagnostic approaches. Therefore, preventative measures should focus on early source control, strict glycemic control, and limiting steroids to COVID-19 patients especially older patients (> 40 years). Early antifungal treatment and surgical techniques such as FESS and necrotic tissue debridement were associated with better prognosis, indicating the efficiency of multidisciplinary medical and surgical teams. https://jidc.org/index.php/journal/article/view/19897corticosteroidsCOVID-19debridementdiabetesendoscopicmucormycosis |
| spellingShingle | Safaa Elserougy Muhammad Abdel-Ghaffar Eman Medhat Ahmed Heiba Weam Shaheen Elham Mostafa Hala Mahfouz Samah Abdel-Hafez Mohammad S Mahfouz Shimaa Afify Omnia Ali Enass El-Sayed Ahmed M Mostafa Ahmed M Salah Anwar Elbatawy Hanan M Elghoneimy Amr A Elshafey Ahmed Abou-ElFotouh Tareq Abdul-Ghani Fatma I Ibrahim Sarah M Samy Manal S Elhussini Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt Journal of Infection in Developing Countries corticosteroids COVID-19 debridement diabetes endoscopic mucormycosis |
| title | Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt |
| title_full | Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt |
| title_fullStr | Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt |
| title_full_unstemmed | Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt |
| title_short | Epidemiologic threats and outcome of evolving COVID-19-associated mucormycosis from a referral hospital in Egypt |
| title_sort | epidemiologic threats and outcome of evolving covid 19 associated mucormycosis from a referral hospital in egypt |
| topic | corticosteroids COVID-19 debridement diabetes endoscopic mucormycosis |
| url | https://jidc.org/index.php/journal/article/view/19897 |
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