The hospitalization rate and clinical characteristics of mucormycosis prior and during COVID-19 pandemic: A single-center study

Authors

  • Mehrdad Estakhr Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-0648-0936
  • Zahra Ghotbi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0001-7111-6519
  • Mahtab Rostamihosseinkhani Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0001-6672-0471
  • Etrat Hooshmandi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Masoud Janipour Department of Otorhinolaryngology-Head and Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
  • Vahid Reza Ostovan Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0003-2407-5915
  • Nima Fadakar Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-4083-5577
  • Hanieh Bazrafshan Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-2661-8373
  • Zahra Bahrami Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Abbas Rahimi-Jaberi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-3402-6060
  • Maryam Poursadeghfard Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Masoumeh Nazeri Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Pariya Kouhi Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Peyman Petramfar Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Sadegh Izadi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Zohreh Barzegar Shiraz University of Medical Sciences, Shiraz, Iran
  • Ehsan Nikzadeh Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-6666-5369
  • Sarvin Sasannia Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
  • Shahram Arsang-Jang Department of Biostatistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • Reza Tabrizi Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran https://orcid.org/0000-0001-7634-3948
  • Behzad Khademi Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-9316-309X
  • Mahsa Kohandel-Shirazi Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-7881-7833
  • Mohammad Saied Salehi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Nahid Ashjazadeh Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-6664-2837
  • Bijan Khademi Department of Otorhinolaryngology-Head and Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mohammad Javad Ashraf Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-4987-8477
  • Owrang Eilami Department of Family Medicine and Infectious Diseases, HIV and AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Amir Roudgari Department of Family Medicine and Infectious Diseases, HIV and AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mohsen Moghaddami Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran https://orcid.org/0000-0001-8015-0313
  • Kamiar Zomorodian Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-3338-7112
  • Hamid Badali Department of Molecular Microbiology and Immunology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX, United States https://orcid.org/0000-0002-6010-8414
  • Afshin Borhani-Haghighi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran https://orcid.org/0000-0002-4131-7990

DOI:

https://doi.org/10.3855/jidc.17371

Keywords:

mucormycosis, SARS-CoV-2, COVID-19, invasive fungal infection, pandemic, glucocorticoids

Abstract

Introduction: There have been some reports of the association between SARS-CoV-2 infection and mucormycosis. This study aims to compare the hospitalization rates and clinical characteristics of mucormycosis before and during the COVID-19 pandemic.

Methodology: In this retrospective study, we compared the hospitalization rate of mucormycosis patients in Namazi hospital in Southern Iran for two periods of 40 months. We defined July 1st, 2018 to February 17th, 2020, as the pre-COVID-19 period and February 18th, 2020, to September 30th, 2021, as the COVID-19 period. In addition, a quadrupled group of hospitalized patients with age and sex-matched SARS-COV-2 infection without any sign of mucormycosis was selected as the control group for COVID-associated mucormycosis.

Result: In the total of 72 mucormycosis patients in the COVID period, 54 patients had a clinical history and a positive RT-PCR, which confirms the diagnosis of SARS-COV2 infection. The hospitalization rate of mucormycosis showed an increase of + 306% (95% CI: + 259%, + 353%) from a monthly average value of 0.26 (95% confidence interval (CI): 0.14, 0.38) in the pre-COVID period to 1.06 in the COVID period. The use of corticosteroids prior to the initiation of hospitalization (p ≤ 0.01), diabetes (DM) (p = 0.04), brain involvement (p = 0.03), orbit involvement (p = 0.04), and sphenoid sinus invasion (p ≤ 0.01) were more common in patients with mucormycosis during the COVID period.

Conclusions: In high-risk patients, especially diabetics, special care to avoid the development of mucormycosis must be taken into account in patients with SARS-COV-2 infection considered for treatment with corticosteroids.

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Published

2023-06-30

How to Cite

1.
Estakhr M, Ghotbi Z, Rostamihosseinkhani M, Hooshmandi E, Janipour M, Ostovan VR, Fadakar N, Bazrafshan H, Bahrami Z, Rahimi-Jaberi A, Poursadeghfard M, Nazeri M, Kouhi P, Petramfar P, Izadi S, Barzegar Z, Nikzadeh E, Sasannia S, Arsang-Jang S, Tabrizi R, Khademi B, Kohandel-Shirazi M, Salehi MS, Ashjazadeh N, Khademi B, Ashraf MJ, Eilami O, Roudgari A, Moghaddami M, Zomorodian K, Badali H, Borhani-Haghighi A (2023) The hospitalization rate and clinical characteristics of mucormycosis prior and during COVID-19 pandemic: A single-center study. J Infect Dev Ctries 17:791–799. doi: 10.3855/jidc.17371

Issue

Vol. 17 No. 06: June 2023

Section

Coronavirus Pandemic

License

Copyright (c) 2023 Mehrdad Estakhr, Zahra Ghotbi, Mahtab Rostamihosseinkhani, Etrat Hooshmandi, Masoud Janipour, Vahid Reza Ostovan, Nima Fadakar, Hanieh Bazrafshan, Zahra Bahrami, Abbas Rahimi-Jaberi , Maryam Poursadeghfard , Masoumeh Nazeri , Pariya Kouhi , Peyman Petrmafar , Sadegh Izadi , Zohreh Barzegar, Ehsan Nikzadeh, Sarvin Sasannia, Shahram Arsang-Jang, Reza Tabrizi, Behzad Khademi , Mahsa Kohandel-Shirazi , Mohammad Saied Salehi , Nahid Ashjazadeh , Bijan Khademi, Mohammad Javad Ashraf , Owrang Eilami , Amir Rudgari , Mohsen Moghaddami, Kamiar Zomorodian, Hamid Badali, Afshin Borhani-Haghighi

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