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The relationship between cumulative dose of immunosuppressive agents and COVID-19-associated mucormycosis: A multicenter cross-sectional study.
Rastkar, Mohsen; SeyedAlinaghi, SeyedAhmad; Asanjarani, Behzad; Siri, Goli; Abdollahi, Hamed; Ghadami, Ladan; Hasibi, Mehrdad; Khodashahi, Rozita; Bagheri, AmirBehzad; Asadollahi-Amin, Ali.
  • Rastkar M; Students' Scientific Research Center, Tehran University of Medical Sciences Tehran Iran.
  • SeyedAlinaghi S; Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors Tehran University of Medical Sciences Tehran Iran.
  • Asanjarani B; Department of Internal Medicine, Amir Alam Hospital Tehran University of Medical Sciences Tehran Iran.
  • Siri G; Department of Internal Medicine, Amir Alam Hospital Tehran University of Medical Sciences Tehran Iran.
  • Abdollahi H; Department of Anesthesia and Critical Care, Amir Alam Hospital Complexes Tehran University of Medical Sciences Tehran Iran.
  • Ghadami L; Department of Health Care Management, Amir Alam Hospital Complexes Tehran University of Medical Sciences Tehran Iran.
  • Hasibi M; Department of Internal Medicine, Amir Alam Hospital Tehran University of Medical Sciences Tehran Iran.
  • Khodashahi R; Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran.
  • Bagheri A; Student Research Committee, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran.
  • Asadollahi-Amin A; Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery Interdisciplinary Consortium on Advanced Motion Performance, Baylor College of Medicine Houston Texas USA.
Health Sci Rep ; 5(6): e950, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2127742
ABSTRACT
Background and

Aims:

Immunosuppressive therapy has a key role in developing coronavirus disease-2019 (COVID-19)-associated mucormycosis. In this study, we investigated the effect of the type and cumulative dose of immunosuppressive agents on COVID-19-associated mucormycosis.

Methods:

We designed a descriptive cross-sectional study involving three COVID-19 hospitals in Iran. Clinical and demographic data were gathered from the medical records and checked by two independent researchers to minimize errors in data collection.

Results:

Seventy-three patients were included in the study. The mean age of cases was 57.41 (SD = 12.64) and 43.8% were female. Among patients, 20.5% were admitted to the intensive care unit (ICU) during COVID-19. Furthermore, 17 patients (23.29%) had a history of diabetes mellitus. Sixty-nine patients (94.52%) had a history of receiving corticosteroids (dexamethasone) during treatment of COVID-19, and of those, five patients (6.85%) received Tocilizumab beside. The mean cumulative dose of corticosteroids prescribed was 185.22 mg (SD = 114.738). The average cumulative dosage of tocilizumab was 720 mg (SD = 178.89). All of the included patients received amphotericin B for mucormycosis treatment, and 42 survived (57.53%). Also, there was a significant relationship between hospitalization in ICU for COVID-19 and the mucormycosis outcome (p = 0.007). However, there weren't any significant associations between cumulative doses of immunosuppressive drugs and mucormycosis outcome (p = 0.52).

Conclusion:

The prevalence of COVID-19-associated mucormycosis is increasing and should be considered in the treatment protocols of COVID-19. Controlling risk factors such as diabetes, malignancy and the administration of immunosuppressive agents based on recommended dosage in validated guidelines are ways to prevent mucormycosis.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Health Sci Rep Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Health Sci Rep Year: 2022 Document Type: Article