Мукормикоз у пациентов с COVID-19

Abstract

Rhinocerebral mucormycosis is characterized by a severe course and is one of the late complications in patients who have undergone COVID-19. For the successful treatment of this disease, the earliest possible diagnosis and the appointment of specific conservative therapy in combination with surgical intervention are necessary. Objective. To study the risk factors for the development of invasive mycoses, the clinical manifestations of this pathology, and the results of its treatment in patients who underwent SARS-CoV-2. Research methods. Retrospective analysis of the case histories of 25 patients with mucormycosis. Demographic, subjective, and objective data (medical history, complaints, endoscopic examination), radiological techniques (CT scans), histological, microscopic and cultural studies as well as the results of medical and surgical treatment were analyzed. Result of the study. Groups of patients with comorbid pathology, potentially predisposed to the development of this disease, as well as groups of drugs, the use of which predisposes to the risk of developing mucormycosis, were identified. Conclusion. The predisposing background to the development of mucormycosis is hyperglycemic conditions and the use of high doses of corticosteroids and broad-spectrum antibiotics as part of the COVID-19 treatment protocol. According to epidemiological data, the largest number of cases of invasive rhinocerebral mucormycosis coincided with the highly virulent SARS-CoV-2 delta strain. Early initiation of specific antifungal therapy combined with surgery results in more effective treatment.