Coronavirus Disease, Diabetes and Glucocorticoid a Terrible Trio for Invasive Mucormycosis: An Observational Study from Northwest Rajasthan

J Assoc Physicians India. 2022 Dec;69(12):11-12.

Abstract

Objective: This study aims to describe the epidemiology, predisposing factors, clinical manifestations, management, and outcome of post-COVID rhino-cerebralorbital mucormycosis.

Methods: This is a prospective observational study of patients with post-COVID RCOM conducted tertiary care hospital during May-June 2021.

Results: The mean age of patients was 49.58±15.12 years and majority (64.80%) were male. The majority of patients were rural, Hindu and illiterate. Diabetes was present 78.10% patients, glucocorticoids were required in 66.30%, and supplemental oxygen was used in 27.60% of patients. Most of the patients developed symptoms of RCOM within 15 days of COVID-19. Majority of patients (46.67%) had stage 3 disease and orbit was involved in 60% of patients. All patients received intravenous antifungal drugs and combined antifungal drugs and surgical debridement was performed in 77.10% patients. Predictor associated with poor outcome were RCOM stage 3c or above and qSOFA score ≥2 at presentation.

Conclusion: Diabetes and glucocorticoids are the most important risk factors for post-COVID RCOM. COVID-19 patients must be followed closely for 2-4 weeks to detect mucormycosis as earlier as possible. Antifungal drugs should be started immediately if clinico-radiological feature suggest RCOM before microbiological confirmation. Combined medical and surgical treatment significantly reduces mortality.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • COVID-19*
  • Diabetes Mellitus* / epidemiology
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Mucormycosis*
  • SARS-CoV-2

Substances

  • Glucocorticoids