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The Relationship Between Cumulative Dose of Immunosuppressive Agents and Covid-19-Associated Mucormycosis: A Multicenter Cross-Sectional Study Publisher



Rastkar M1 ; Seyedalinaghi S2 ; Asanjarani B3 ; Siri G3 ; Abdollahi H4 ; Ghadami L5 ; Hasibi M3 ; Khodashahi R6 ; Bagheri A7, 8 ; Asadollahiamin A2
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Authors Affiliations
  1. 1. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Anesthesia and Critical Care, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Health Care Management, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  7. 7. Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  8. 8. Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Interdisciplinary Consortium on Advanced Motion Performance, Baylor College of Medicine, Houston, TX, United States

Source: Health Science Reports Published:2022


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. © 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.
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