Demographic characteristics and risk factors for invasive fungal sinusitis in the context of COVID-19: A systematic review and meta-analysis.

ABSTRACT

OBJECTIVES: To identify the demographic characteristics and potential risk factors of invasive fungal sinusitis (IFS) patients with Coronavirus Disease in 2019 (COVID-19). METHODS: Web of Science, Embase, the Cochrane Library, and PubMed were searched from database inception to August 2023 using the combination of medical searching heading terms "invasive fungal sinusitis" and "COVID-19" and their free words. The research protocol was registered on PROSPERO (CRD42023467175). RESULTS: A total of 53 studies were included. The mean age of IFS patients with COVID-19 was 53.72 (95% credible interval [CI] 51.08, 56.36), with 66% males (95% CI 0.62, 0.70), and 81% diabetes (95% CI 0.77, 0.86). The mean time from COVID-19 diagnosis to IFS onset was 19.09 days (95% CI 16.96, 21.22). The percentage of patients with COVID-19 PCR positivity was 33% (95% CI 0.21, 0.45). Overall, 71% of patients receiving steroid therapy during COVID-19 infection (95% CI 0.63, 0.78). The odds ratio of diabetes mellitus, steroid administration, and COVID-19 PCR positivity were 6.09, 2.21, and 1.82, respectively. COVID-19 infection did not affect the IFS stage. CONCLUSION: IFS patients with COVID-19 had an average age of 53.72 years and were predominantly males, with a mean interval of 19.09 days from COVID-19 diagnosis to IFS onset. Diabetes, steroid administration, and COVID-19 PCR positivity were risk factors.