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COVID-19 Associated Mucormycosis.

Sana Tazeem1, A Nagaraju2, Hazeera Begum3

  • 1Osmania Medical College, Hyderabad, India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|June 26, 2023
PubMed
Summary

The study found that Coronavirus Disease-2019 Associated Mucormycosis (CAM) is an epidemic in India, often linked to diabetes and steroid use during COVID-19 treatment. Early diagnosis and multidisciplinary care are crucial for improving outcomes in these fungal infections.

Keywords:
CAMCOVID-19CorticosteroidsDiabetes mellitusRhino-orbital mucormycosis

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Area of Science:

  • Infectious Diseases
  • Mycology
  • Epidemiology

Background:

  • Mucormycosis is a severe opportunistic fungal infection prevalent in immunocompromised individuals.
  • The incidence of mucormycosis has surged among Coronavirus Disease-2019 (COVID-19) patients in India, escalating from endemic to epidemic levels.
  • Diabetes and corticosteroid use are significant risk factors associated with COVID-19-related mucormycosis.

Purpose of the Study:

  • To investigate the epidemiology, management strategies, and patient outcomes of COVID-19 Associated Mucormycosis (CAM).
  • To determine the specific roles of diabetes mellitus and corticosteroid administration in the development of CAM.

Main Methods:

  • A hospital-based observational study was conducted at a tertiary care facility.
  • The study included patients diagnosed with rhino-orbital mucormycosis and a recent history of COVID-19 infection.
  • Data on comorbidities, treatment, and outcomes were collected and analyzed.

Main Results:

  • Out of 205 patients, 81% had Diabetes Mellitus, with 36.6% diagnosed during COVID-19 treatment.
  • Corticosteroids were administered to 78.5% of patients, often inappropriately (26.7%).
  • Mortality was higher in diabetic patients, with 80% of deaths occurring in this subgroup; 85.4% of all patients survived 12 weeks.

Conclusions:

  • COVID-19 Associated Mucormycosis presents a significant public health challenge in India, characterized by high rates of diabetes and corticosteroid use.
  • Effective management requires increased public awareness, prompt diagnosis, and a collaborative, multidisciplinary approach to improve patient prognosis.
  • Addressing the underlying risk factors, particularly diabetes control and judicious steroid use, is critical in combating this devastating infection.