RESUMO
Background: Mucormycosis is a serious life-threatening fungal infection that recently made severe sudden and devastating surge during the second wave of the COVID-19 epidemic with a mortality rate of up to 50%. Although the causality link between COVID-19 and rhino-orbito-cerebral mucormycosis (ROCM) remains unclear, many factors including poor diabetes control, high doses of steroids, viral-induced lymphopenia, and cytokine storm have been attributed to ROCM in patients with COVID-19. Orienting to risk factors and early recognition of this potentially fatal opportunistic infection is the key to optimal management and improved outcomes. In these contexts, we conducted a prospective study for 33 patients admitted to our tertiary hospital to determine the risk factors for ROCM in patients with COVID-19 and the cumulative mortality rates. Result(s): This study found a statistically significant relation between the fate of death in COVID-MUCOR patients who had presented fever, ophthalmoplegia, facial skin necrosis, and visual loss with those who received dose of steroid to control their respiratory symptoms P < 0.001. Death from COVID-MUCOR was statistically significant related to the prolonged interval from the onset of the symptoms to start of treatment and intervention. Also, it was found that there was a significant decrease in duration between COVID-19 infection and the start of mucormycosis (days) with incidence of DKA on admission. Nineteen (57.6%) of the patients had uncontrolled diabetes mellitus (hemoglobin A1C (HbA1c) of > 7.0%). Conclusion(s): Mucormycosis epidemic was precipitated by a unique confluence of risk factors: diabetes mellitus, widespread use of steroids, and perhaps SARS-CoV-2 infection itself. Restricting steroid use in patients with severe COVID-19 requiring oxygen therapy, and screening for and optimally controlling hyperglycemia, can prevent COVID-MUCOR in a large majority.Copyright © 2023, The Author(s).
RESUMO
Background: The prevalence of olfactory/gustatory dysfunctions among hospitalized SARS-CoV-2-infected patients is highly variable between different studies, ranging from 5.6% in the Asian population to 86% in the European population. The study aimed to detect the prevalence and the recovery of olfactory/gustatory dysfunctions in hospitalized SARS-CoV-2-infected patients in an Egyptian tertiary care center. A total of 579 hospitalized patients were enrolled. Demographic data as well as upper respiratory tract symptoms including olfactory/gustatory dysfunctions and other risk factors were documented. Then the recovery of olfactory/gustatory dysfunctions after 6 months was followed up. Results: 50.6% had olfactory/gustatory dysfunctions (24.2% had a total smell and taste loss). A logistic regression analysis revealed a statistical significance between olfactory/gustatory dysfunctions and female gender and presence. Most patients (88.4%) reported partial or complete recovery during the 6 months (28.0% and 60.4%, respectively), while 11.6% of patients did not recover. The median time to start recovery was 3 days, and the median time to the best recovery was 22 days. Conclusions: Olfactory/gustatory dysfunctions should be recognized for early detection of COVID-19 infection. Most recovery of olfactory/gustatory dysfunction in COVID-19 infection starts within 3 days and reaches the best recovery within 19 to 24 days. Female gender and the presence of general symptoms are associated with olfactory/gustatory dysfunctions in the hospitalized COVID-19 patients.