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Clinical Profile of Mucormycosis Patients during Coronavirus Disease 2019 Pandemic: A Retrospective Observational
Badal Gondane1, Shailendra Kumar Jain2, Simmi Dube3
1Junior Resident, Department of Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
Background:
During the coronavirus disease (COVID-19) pandemic, an increased incidence of mucormycosis infection was noted globally, the majority being from India. We aimed to study the clinical profile of the mucormycosis patients during the COVID-19 pandemic admitted at tertiary care centers.
Materials And Methods:
This is a retrospective record-based observation study conducted at Gandhi Medical College, Bhopal. All suspected or laboratory-proven mucormycosis patients were included. Detailed data on demography, clinical features, risk factors, laboratory/radiological findings, and outcomes were recorded.
Results:
A total of 288 patients were enrolled and 121(42%) showed mucormycosis on potassium hydroxide (KOH) mount. The mean age was 51.52 ± 10.88 years, male:female ratio was 2.3:1. Most common symptom was facial swelling/pain and fever. The most common risk factor was COVID-19 infection (78.5%) followed by the presence of diabetes mellitus (DM) (70.8%) out of which 152 (52.8%) patients were previously diagnosed cases and 52 (18%) patients were newly diagnosed, 159 (55.2%) had a history of corticosteroid use, 87 (30.2%) had a history of use of oxygen support and 67 (23.2%) had hypertension. Most patients had invasion limited to sinus (46.5%) but the presence of DM was associated with an increased risk of cerebral invasion. Out of 288 patients admitted with mucormycosis, 31 patients collapsed to death while the remaining 257 patients were discharged from the hospital.
Conclusion:
It is observed that during the COVID-19 pandemic, hyperglycemia and inappropriate use of corticosteroids were associated with an increased risk of development of mucormycosis in patients with or without DM. We conclude that regular blood glucose monitoring, adequate glycemic control, and judicious evidence-based use of corticosteroids and immunosuppressants in COVID-19 are recommended to reduce the emergence of mucormycosis in such circumstances.
Insights
The COVID-19 pandemic saw a rise in mucormycosis, especially in India. High blood sugar and steroid misuse were key risk factors, highlighting the need for careful management in patients.
Area of Science:
- Infectious Diseases
- Mycology
- Epidemiology
Background:
- Increased incidence of mucormycosis observed globally during the COVID-19 pandemic, with a majority of cases originating from India.
- Mucormycosis, a serious fungal infection, poses a significant threat, particularly to immunocompromised individuals.
Purpose of the Study:
- To investigate the clinical characteristics and risk factors of mucormycosis patients during the COVID-19 pandemic.
- To understand the association between COVID-19, diabetes mellitus, corticosteroid use, and mucormycosis development.
Main Methods:
- Retrospective, record-based observational study.
- Inclusion of all suspected or laboratory-proven mucormycosis cases.
- Data collection on demography, clinical features, risk factors, laboratory/radiological findings, and outcomes.
Main Results:
- 288 patients enrolled; 42% confirmed mucormycosis via KOH mount.
- Common risk factors: COVID-19 (78.5%), diabetes mellitus (70.8%), corticosteroid use (55.2%).
- Diabetes mellitus associated with increased risk of cerebral invasion; 31 deaths reported.
Conclusions:
- Hyperglycemia and inappropriate corticosteroid use are linked to increased mucormycosis risk in COVID-19 patients.
- Recommendations include regular blood glucose monitoring and judicious use of corticosteroids and immunosuppressants.
- Effective management strategies are crucial to mitigate mucormycosis emergence during pandemics.
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