COVID-19 and Fournier’s Gangrene: Is there a Correlation Between Both Diseases?

Abstract

Background: Reports on the development of Fournier's Gangrene (FG) in patients with coronavirus disease 2019 (COVID-19) are rare. Aim: This study reports a series of cases of patients with both diseases and to summarize the literature on the subject. Methods: We retrospectively examined electronic medical records dated between March 2020 and December 2021 of all adult patients with COVID-19 admitted to the Clinics Hospital of Ribeirão Preto (HCFMRP-USP) to identify those who had a diagnosis of FG. The diagnosis of COVID-19 was made by RT-PCR. We assessed the following patient characteristics: age; sex; tobacco use; laboratory data; and comorbidities such as human immunodeficiency virus (HIV), obesity, diabetes mellitus, systemic arterial hypertension, and alcoholism. Results: Four patients met the inclusion criteria. All the patients were female and had at least two comorbidities, including obesity (n=4, 100%), systemic arterial hypertension (n=3, 75%), diabetes mellitus (n=2, 50%), cardiovascular disease (n=1, 25%), chronic kidney disease (n=1, 25%), and hematologic disorders (n=1, 25%). They were all admitted to the intensive care unit and underwent surgical debridement under anesthesia. All the patients received hyperbaric oxygen therapy. The mean age was 62.75 years (range 60-66 years), and the mean length of stay was 30 days (range 22-37 days). One patient died (n=1, 25%). Conclusion: This is the first report in the literature on a series of cases of FG in patients with COVID-19. FG associated with COVID-19 is a serious, potentially lethal condition.