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COVID-19-associated mucormycosis: a systematic review and meta-analysis of 958 cases.
Özbek, Lasin; Topçu, Umur; Manay, Mehtap; Esen, Bugra Han; Bektas, Sevval Nur; Aydin, Serhat; Özdemir, Baris; Khostelidi, Sofya N; Klimko, Nikolai; Cornely, Oliver; Zakhour, Johnny; Kanj, Souha S; Seidel, Danila; Hoenigl, Martin; Ergönül, Önder.
Afiliación
  • Özbek L; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Topçu U; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Manay M; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Esen BH; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Bektas SN; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Aydin S; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Özdemir B; School of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
  • Khostelidi SN; Department of Clinical Mycology, Allergy, and Immunology, I. I. Mechnikov North-Western State Medical University, St Petersburg, Russia.
  • Klimko N; Department of Clinical Mycology, Allergy, and Immunology, I. I. Mechnikov North-Western State Medical University, St Petersburg, Russia.
  • Cornely O; Division of Infectious Diseases (ECMM Diamond Excellence Center), Department of Internal Medicine, University Hospital Cologne, Cologne, Germany.
  • Zakhour J; Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
  • Kanj SS; Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
  • Seidel D; Division of Infectious Diseases (ECMM Diamond Excellence Center), Department of Internal Medicine, University Hospital Cologne, Cologne, Germany.
  • Hoenigl M; Division of Infectious Diseases (ECMM Diamond Excellence Center), Medical University of Graz, Graz, Austria.
  • Ergönül Ö; Department of Infectious Diseases and Clinical Microbiology, Koç University, School of Medicine, Istanbul, Turkey; Koç University Isbank Center for Infectious Diseases, Koç University, Istanbul, Turkey. Electronic address: oergonul@ku.edu.tr.
Clin Microbiol Infect ; 29(6): 722-731, 2023 Jun.
Article en En | MEDLINE | ID: mdl-36921716
BACKGROUND: Mucormycosis, a rare fungal infection, has shown an increase in the number of reported cases during the COVID-19 pandemic. OBJECTIVES: To provide a comprehensive insight into the characteristics of COVID-19-associated mucormycosis, through a systematic review and meta-analysis. METHODS OF DATA SYNTHESIS: Demographic information and clinical features were documented for each patient. Logistic regression analysis was used to predict the risk of mortality. DATA SOURCES: PubMed, Scopus, Web of Science, Cochrane, CINAHL, Ovid MEDLINE, and FungiSCOPE. STUDY ELIGIBILITY CRITERIA: Studies reporting individual-level information in patients with adult COVID-19-associated mucormycosis (CAM) between 1 January 2020 and 28 December 2022. PARTICIPANTS: Adults who developed mucormycosis during or after COVID-19. INTERVENTIONS: Patients with and without individual clinical variables were compared. ASSESSMENT OF RISK OF BIAS: Quality assessment was performed based on the National Institutes of Health quality assessment tool for case series studies. RESULTS: Nine hundred fifty-eight individual cases reported from 45 countries were eligible. 88.1% (844/958) were reported from low- or middle-income countries. Corticosteroid use for COVID-19 (78.5%, 619/789) and diabetes (77.9%, 738/948) were common. Diabetic ketoacidosis (p < 0.001), history of malignancy (p < 0.001), underlying pulmonary (p 0.017), or renal disease (p < 0.001), obesity (p < 0.001), hypertension (p 0.040), age (>65 years) (p 0.001), Aspergillus coinfection (p 0.037), and tocilizumab use during COVID-19 (p 0.018) increased the mortality. CAM occurred on an average of 22 days after COVID-19 and 8 days after hospitalization. Diagnosis of mucormycosis in patients with Aspergillus coinfection and pulmonary mucormycosis was made on average 15.4 days (range, 0-35 days) and 14.0 days (range, 0-53 days) after hospitalization, respectively. Cutaneous mucormycosis accounted for <1% of the cases. The overall mortality rate was 38.9% (303/780). CONCLUSION: Mortality of CAM was high, and most reports were from low- or middle-income countries. We detected novel risk factors for CAM, such as older age, specific comorbidities, Aspergillus coinfection, and tocilizumab use, in addition to the previously identified factors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Coinfección / COVID-19 / Mucormicosis Tipo de estudio: Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Aged / Humans Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Coinfección / COVID-19 / Mucormicosis Tipo de estudio: Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Aged / Humans Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Reino Unido