Rhino-orbito-cerebral mucormycosis during the COVID-19 third wave in 2021: an Egyptian preliminary report from a single tertiary hospital

Alloush, Taha Kamel; Mansour, Osama; Alloush, Adel T; Roushdy, Tamer; Hamid, Eman; Elshamy, Mahmoud Ibrahim; Shokri, Hossam M.

doi:10.1007/s10072-021-05740-y

Cited by 18 publications

(11 citation statements)

References 58 publications

(58 reference statements)

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“…[ 66 ] Egypt Case series Single-center 14 – [29–77] 71 (10) 100 (14) Alloush TK. [ 67 ] Egypt Case series Single-center 14 May 2021–Jun 2021 [49–82] 64 (9) 93 (!3) Seidel D. [ 68 ] Germany Case series Multi-center 13 Feb 2020–Jun 2021 [30–75] 62 (8) 23 (3) Author HTN, % (N) CKD, % (N) Immunosuppression, % (N) Malignancy, % (N) Hypoxia, % (N) Mechanical ventilation, % (N) Corticosteroids treatment, % (N) ICU admission, % (N) Moorthy A. [ 20 ] – – – – – – 88 (15) – El-Kholy NA.…”

Section: Resultsmentioning

confidence: 99%

“…[ 66 ] – – – – – – 21 (3) Alloush TK. [ 67 ] 43 (6) 14 (2) – 100 (14) 0 (0) 93 (13) – Seidel D. [ 68 ] – 7.7 (1) 38 (5) – 79 (11) 79 (11) 79 (11) Value is shown as mean ± SD or median [range]. The columns of hypoxia, mechanical ventilation, corticosteroids treatment, and ICU admission was the data regarding COVID-19 severity and management.…”

Section: Resultsmentioning

confidence: 99%

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Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Watanabe

Mitaka

et al. 2022

Mycopathologia

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The recent increase of COVID-19-associated mucormycosis (CAM) has been commanding global attention. However, basic epidemiologic characteristics have not firmly been established. In this systematic review and meta-analysis, we sought to determine the clinical manifestations, potential risk factors, and outcomes of CAM. Observational studies reporting CAM were searched with PubMed and EMBASE databases in January 2022. We collected data on comorbidities and treatment for COVID-19, and performed a one-group meta-analysis on the frequency of orbital exenteration procedure and mortality of CAM using a random-effect model. Fifty-one observational studies, including a total of 2,312 patients with proven CAM, were identified. Among the 51 studies, 37 were conducted in India, 8 in Egypt, and 6 in other countries. The most common comorbidity was diabetes mellitus (82%). While 57% required oxygenation, 77% received systemic corticosteroids. Among CAM, 97% were rhino-orbital-cerebral (ROCM), and 2.7% were pulmonary mucormycosis. Usual presentations were headache (54%), periorbital swelling/pain (53%), facial swelling/pain (43%), ophthalmoplegia (42%), proptosis (41%), and nasal discharge/congestion (36%). Regarding the outcomes, orbital exenteration was performed in 17% (95% CI: 12–21%, I 2 = 83%) of the COVID-19-associated ROCM patients. The mortality of CAM was 29% (95% CI; 22–36%, I 2 = 92%). In conclusion, this systematic review and meta-analysis indicated that the most prevalent type of CAM was ROCM, and most CAM patients had diabetes mellitus and received systemic glucocorticoids. Clinicians in the endemic areas should have a high index of suspicion for this invasive fungal complication of COVID-19 when a diabetic patient who received high-dose systemic glucocorticoids developed rhino-orbital symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Watanabe

Mitaka

et al. 2022

Mycopathologia

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“…They identified 12 cases with ROCM with mean age of 51 years, half of them were males and over 80% of them had poorly controlled diabetes mellitus. Also, Alloush et al, 11 Elkhly et al, 12 and Fouad et al 13 reported the same findings.…”

Section: Discussionmentioning

confidence: 57%

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt

Shabana

Eldesouky

Elbedewy

2022

OPTH

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“…Throughout the Covid-19 pandemic, an increased incidence of Covid-19–associated mucormycosis (CAM), especially among patients with uncontrolled hyperglycemia, has been observed in many countries [ 19 , 20 ]. The soaring second wave of Covid-19 infection was found to be associated with an exponential increase in the incidence of CAM [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 associated rhino-orbito-cerebral mucormycosis, risk factors and outcome predictors; a multicentric study

et al. 2022

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Background Since the onset of the Covid-19 pandemic, an increase in mucormycosis cases has been observed in many countries, including Iran. However, the role of covid-19 and associated risk factors have not been thoroughly investigated. Objective This study is designed to identify epidemiologic characteristics, risk factors, and outcome predictors of Covid-19-Associated Rhino-Orbito-Cerebral Mucormycosis (C-ROCM). Methods Data of pathology proven Covid Associated ROCM cases were retrospectively obtained from 7 tertiary care centers throughout Iran from February 20, 2021, to July 22, 2021. Univariate and multivariate analyses were performed using binary logistic regression to assess the effects of various factors on the outcome. Results A total of 132 patients with C-ROCM were included in the study. The mean age of patients was 61.6 ± 13.9 (60.6% male). In 12 patients (9.1%), both eyes were involved. Diabetes was the most common comorbidity (94.7%). The mortality rate was 9.1%, higher in males (12.5%) than females (3.8%). Severe vision impairment was seen in 58 patients (43.9%). Main factors that had a negative impact on the outcome in the univariate analysis include older age ( P < 0.001), higher steroid dosage ( P < 0.001), higher HbA1c level ( P < 0.001), Covid-19 severity ( P < 0.001), and brain involvement ( P < 0.001). However, in the multivariate analysis, the effects of age ( P = 0.062), steroid dosage ( P = 0.226), and Covid-19 intensity ( P = 0.084) decreased, and the difference was no longer statistically significant. CRAO was a predictor of mortality in the univariate analysis ( P = 0.008, OR = 4.50), but in the multivariate analysis, this effect decreased and was no longer significant ( P = 0.125). Conclusion The risk of C-ROCM and its complications may increase in patients with more severe Covid-19, steroid over-prescription, ICU admission due to Covid-19, and poor glycemic control during and after Covid-19 treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s10792-022-02536-7.

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Rhino-orbito-cerebral mucormycosis during the COVID-19 third wave in 2021: an Egyptian preliminary report from a single tertiary hospital

Cited by 18 publications

References 58 publications

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt

COVID-19 associated rhino-orbito-cerebral mucormycosis, risk factors and outcome predictors; a multicentric study

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