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

• Published in: Journal of the Association of Physicians of India Vol. 69; no. 12; pp. 11 - 12
• Main Authors: Nehara, Hardeva Ram, Kumawat, Sahdev, Gupta, Jigyasa, Gupta, Gaurav, Sirohi, Parmendra, Ih, Sunil, Gupta, Balkishan
• Format: Journal Article
• Language: English
• Published: India 01.12.2022
• Subjects: Adult; COVID-19; Diabetes Mellitus - epidemiology; Female; Glucocorticoids - therapeutic use; Humans; India - epidemiology; Male; Middle Aged; Mucormycosis; SARS-CoV-2; India
• ISSN: 0004-5772

This study aims to describe the epidemiology, predisposing factors, clinical manifestations, management, and outcome of post-COVID rhino-cerebralorbital mucormycosis. This is a prospective observational study of patients with post-COVID RCOM conducted tertiary care hospital during May-June 2021. 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. 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.