Associations between onychomycosis and COVID-19 clinical outcomes: a retrospective cohort study from a US metropolitan center

Rakita, Uros; Kaundinya, Trisha; Feldman, SR; Nelson, Kamaria; Maner, Brittany; Manjunath, Jaya; Schwartzman, Gabrielle; Lane, Brittany; Silverberg, Jonathan I.

doi:10.1007/s00403-021-02299-8

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Diabetic patients suffering with onychomycosis can be more prone to COVID-19 and the response to medicines is also poor in these patients. Recently, Rakita et al [10] in their study also suggested that diabetic patient with onychomycosis is an indicator of more severe COVID-19 and poor out-comes. In their experiment they found that the onychomycosis was a signi cant independent risk factor for COVID-19 severity, hospitalization and receiving supplementary oxygen therapy.…”

Section: Resultsmentioning

confidence: 93%

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Prevalence of onychomycosis among diabetic population of District Doda (UT of J&K, India) - a five year survey

Kotwal¹,

Sumbali

2023

Preprint

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Onychomycosis, which is the chronic fungal infection of finger and toe nails, is too prevalent in persons suffering with diabetes mellitus. Diabetes generally make a person more prone to a number of diseases due to their weakened immune system. Diabetics are almost three times more likely to develop onychomycosis than non-diabetics. In our present study, out of the 370 detected diabetic patients (190 males and 180 females), a total of 45 cases were found to be positive for onychomycosis, which showed a prevalence percentage of 12.16%. 35 onychomycotic male patients with a prevalence percentage of 9.46% and 10 onychomycotic female patients with a prevalence percentage of 2.70% with different clinical symptoms viz., Distal lateral subungual onychomycosis (DLSO), Proximal subungual onychomycosis (PSO), White superficial onychomycosis (WSO) and Total dystrophic onychomycosis (TDO) were reported. A total of 5 dermatophytes, 12 non-dermatophytes (yeast-like fungi) and 28 non-dermatophytes (filamentous fungi) were isolated from the nails of detected diabetic patients. The study also indicates that diabetic males are 3.5 times more prone to onychomycosis than diabetic females. This high prevalence of onychomycosis in diabetics is attributed to a combination of host factors including impaired glycaemic index, ischaemia, neuropathy and local immune-suppression. Onychomycosis can be especially important for some specific occupational groups because of their regular contact with soil, dirt and dust. Such people of the society, which depend upon physical labour for earning, such as, the farmers, gardeners, sweepers, maidservants, labourers, miners, etc., may be more prone to dermatophytic and non-dermatophytic onychomycosis and if they are diabetic then situation will become more complicated for them. This study also found that among detected diabetic patients highest prevalence rate of onychomycosis was found in employees (35.6%), farmers (24.4%), house-wives (17.8%), business-men (11.1%) and labourers (11.1%). Onychomycosis is a significant predictor for the development of secondary infections and foot ulcers in diabetes. Since, diabetics have vascular and nerve impairment, any minor injury to feet including a nail fungal infection can lead to more serious complications. Diabetics may have increased difficulty in doing regular foot check-ups due to obesity or retinopathy or cataracts, which may contribute to higher risk of developing complications from onychomycosis. In addition, symptoms go away very slowly and may take a year or more for the entire replacement of the old and infected nail. The study also found a correlation between the increasing age, diabetes and onychomycosis.

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Section: Resultsmentioning

confidence: 93%

“…genetic defects [8] and recently the COVID-19 SARS-CoV-2 infection [9,10]. As the population ages, there are corresponding chronic health problems that emerge, such as, diabetes, hypertension, thyroid and poor peripheral circulation.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of onychomycosis among diabetic population of District Doda (UT of J&K, India) - a five year survey

Kotwal¹,

Sumbali

2023

Preprint

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“…

We read with interest Rakita et al's retrospective cohort study investigating SARS-CoV-2 severity in adult outpatients and inpatients with onychomycosis and other skin diseases [1]. The authors reported that 23% of SARS-CoV-2-positive patients with a dermatologic condition had onychomycosis.

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confidence: 99%

Don’t blame the nails for SARS-CoV-2 hospitalizations and mortality

2022

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We read with interest Rakita et al.'s retrospective cohort study investigating SARS-CoV-2 severity in adult outpatients and inpatients with onychomycosis and other skin diseases [1]. The authors reported that 23% of SARS-CoV-2-positive patients with a dermatologic condition had onychomycosis. COVID-19 patients with onychomycosis vs. COVID-19 patients with a different dermatologic condition were more likely to be hospitalized, seek in-patient care, require oxygen therapy, and have severe-critical COVID-19 with a higher mortality rate. In this letter, we analyze the methodology used by Rakita et al., and review the literature on prevalence of onychomycosis and long-term outcomes.Rakita et al. reported that nearly 25% of SARS-CoV-2 patients with dermatologic conditions had onychomycosis. A review of 21 North American hospitals found a hospital prevalence of 8.9% (95% CI 4.3-13.6%) and a population prevalence of 4.3% (95% CI 1.9-6.8) for onychomycosis after excluding studies with diagnosis based on clinical examination only [2]. Therefore, the remarkably high rate reported by Rakita et al. is likely due to problematic methodology with onychomycosis diagnosis, with patients "diagnosed clinically by a dermatologist and confirmed with culture analysis as needed". The diagnosis of onychomycosis cannot be made using clinical examination alone. It requires mycological confirmation [3]. Therefore, many of

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Prevalence and Comparison of Superficial-Cutaneous Fungal Infections Before and During the COVID-19 Pandemic in Shiraz, Iran: A Retrospective Study (2018–2021)

Jabrodini,

Bahrololuom,

Amirinia

et al. 2023

Indian J Microbiol

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Associations between onychomycosis and COVID-19 clinical outcomes: a retrospective cohort study from a US metropolitan center

Cited by 4 publications

References 22 publications

Prevalence of onychomycosis among diabetic population of District Doda (UT of J&K, India) - a five year survey

Prevalence of onychomycosis among diabetic population of District Doda (UT of J&K, India) - a five year survey

Don’t blame the nails for SARS-CoV-2 hospitalizations and mortality

Prevalence and Comparison of Superficial-Cutaneous Fungal Infections Before and During the COVID-19 Pandemic in Shiraz, Iran: A Retrospective Study (2018–2021)

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Associations between onychomycosis and COVID-19 clinical outcomes: a retrospective cohort study from a US metropolitan center

Cited by 4 publications

References 22 publications

Prevalence of onychomycosis among diabetic population of District Doda (UT of J&amp;K, India) - a five year survey

Prevalence of onychomycosis among diabetic population of District Doda (UT of J&amp;K, India) - a five year survey

Don’t blame the nails for SARS-CoV-2 hospitalizations and mortality

Prevalence and Comparison of Superficial-Cutaneous Fungal Infections Before and During the COVID-19 Pandemic in Shiraz, Iran: A Retrospective Study (2018–2021)

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Prevalence of onychomycosis among diabetic population of District Doda (UT of J&K, India) - a five year survey

Prevalence of onychomycosis among diabetic population of District Doda (UT of J&K, India) - a five year survey