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@article{1796259,
author = {Riad, Abanoub and Shabaan, Alshaimaa Ahmed and Issa, Julien and Ibrahim, Sally and Amer, Hatem and Mansy, Yossef and Kassem, Islam and Kassem, Amira Bisher and Howaldt, HansandPeter and Klugar, Miloslav and Attia, Sameh},
article_location = {Basel},
article_number = {10},
doi = {http://dx.doi.org/10.3390/jof7100837},
keywords = {co-infection; COVID-19; cross-infection; Mucorales; mucormycosis; mycoses; review; Rhizopus; risk factors; steroids},
language = {eng},
issn = {2309-608X},
journal = {Journal of Fungi},
title = {COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors},
url = {https://www.mdpi.com/2309-608X/7/10/837},
volume = {7},
year = {2021}
}
TY - JOUR
ID - 1796259
AU - Riad, Abanoub - Shabaan, Alshaimaa Ahmed - Issa, Julien - Ibrahim, Sally - Amer, Hatem - Mansy, Yossef - Kassem, Islam - Kassem, Amira Bisher - Howaldt, Hans-Peter - Klugar, Miloslav - Attia, Sameh
PY - 2021
TI - COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors
JF - Journal of Fungi
VL - 7
IS - 10
SP - 1-23
EP - 1-23
PB - MDPI
SN - 2309608X
KW - co-infection
KW - COVID-19
KW - cross-infection
KW - Mucorales
KW - mucormycosis
KW - mycoses
KW - review
KW - Rhizopus
KW - risk factors
KW - steroids
UR - https://www.mdpi.com/2309-608X/7/10/837
N2 - Background: Since the novel coronavirus disease (COVID-19) outbreak, the cases of COVID-19 co-infections have been increasingly reported worldwide. Mucormycosis, an opportunistic fungal infection caused by members of the Mucorales order, had been frequently isolated in severely and critically ill COVID-19 patients. Methods: Initially, the anamnestic, clinical, and paraclinical features of seven COVID-19-associated mucormycosis (CAM) cases from Egypt were thoroughly reported. Subsequently, an extensive review of the literature was carried out to describe the characteristics of CAM cases globally, aiming to explore the potential risk factors of mortality in CAM patients. Results: Out of the seven reported patients in the case series, five (71.4%) were males, six (85.7%) had diabetes mellitus, and three (42.9%) had cardiovascular disease. All patients exhibited various forms of facial deformities under the computed tomography scanning, and two of them tested positive for Mucorales using the polymerase chain reaction (PCR) testing. Liposomal amphotericin B (LAmB) was prescribed to all cases, and none of them died until the end of the follow-up. On reviewing the literature, 191 cases were reported worldwide, of which 74.4% were males, 83.2% were from low-middle income countries, and 51.4% were aged 55 years old or below. Diabetes mellitus (79.1%), chronic hypertension (30%), and renal disease/failure (13.6%) were the most common medical comorbidities, while steroids (64.5%) were the most frequently prescribed medication for COVID-19, followed by Remdesivir (18.2%), antibiotics (12.7%), and Tocilizumab (5.5%). Conclusions: As the majority of the included studies were observational studies, the obtained evidence needs to be interpreted carefully. Diabetes, steroids, and Remdesivir were not associated with increased mortality risk, thus confirming that steroids used to manage severe and critical COVID-19 patients should not be discontinued. Lung involvement, bilateral manifestation, and Rhizopus isolation were associated with increased mortality risk, thus confirming that proactive screening is imperative, especially for critically ill patients. Finally, surgical management and antimycotic medications, e.g., amphotericin B and posaconazole, were associated with decreased mortality risk, thus confirming their effectiveness.
ER -
RIAD, Abanoub, Alshaimaa Ahmed SHABAAN, Julien ISSA, Sally IBRAHIM, Hatem AMER, Yossef MANSY, Islam KASSEM, Amira Bisher KASSEM, Hans-Peter HOWALDT, Miloslav KLUGAR and Sameh ATTIA. COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors. \textit{Journal of Fungi}. Basel: MDPI, 2021, vol.~7, No~10, p.~1-23. ISSN~2309-608X. Available from: https://dx.doi.org/10.3390/jof7100837.
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