A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)

Background: Second wave of coronavirus disease 2019 (Covid-19) pandemic has been particularly devastating in India. COVID-19 and mucormycosis (also known as black fungus) are causing comorbid conditions to worsen the extent of infection and mortality rates especially in India. Mucormycosis can invol...

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Main Authors: Pallavi Indurkar, Aashutosh Asati, Yasmeen Siddiqui, Shubhangi Nayak, Manoj Indurkar
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2022-05-01
Series:Asian Journal of Medical Sciences
Subjects:
Online Access:https://www.nepjol.info/index.php/AJMS/article/view/43940
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author Pallavi Indurkar
Aashutosh Asati
Yasmeen Siddiqui
Shubhangi Nayak
Manoj Indurkar
author_facet Pallavi Indurkar
Aashutosh Asati
Yasmeen Siddiqui
Shubhangi Nayak
Manoj Indurkar
author_sort Pallavi Indurkar
collection DOAJ
description Background: Second wave of coronavirus disease 2019 (Covid-19) pandemic has been particularly devastating in India. COVID-19 and mucormycosis (also known as black fungus) are causing comorbid conditions to worsen the extent of infection and mortality rates especially in India. Mucormycosis can involve nose, sinuses, orbit, central nervous system, lung (pulmonary), gastrointestinal tract any many other organs, but rhino orbital cerebral mucormycosis is the most common variety seen. Rapidity of dissemination of mucormycosis is an extraordinary phenomenon and a delay in the diagnosis could be fatal. Aims and Objectives: The objective of this study is to document the clinical features, radiological extent, risk factors, management, and outcome of mucormycosis. Materials and Methods: The study was retrospective observational study. Eighty-two mucormycosis patients admitted in SGMH Rewa were selected as study subjects. Data regarding clinical features, radiological extent, associated risk factors, comorbidities, management during hospital stay, and outcome of mucormycosis patients were collected on excel sheet and analyzed using appropriate statistical tests. Results: In our study, majority of the patients were unvaccinated (88%). Most common presenting complaint was nasal congestion with or without discharge in 78% patients followed by Facial swelling, visual disturbances, facial weakness, dental pain, etc. On CT or magnetic resonance imaging examination, all cases of mucormycosis had maxillary sinus (100%) involvement, followed by ethmoid (82%) and sphenoid (78%) sinuses. Diabetes mellitus was most common comorbidity seen in 52% cases. About 83% cases had history of receiving high dose steroid intravenously during management of COVID illness. Among study cases 72% patients have taken oxygen supplementation for more than 72 h, for COVID-19 pneumonia before hospitalization for mucormycosis. Therapy of Liposomal Amphotericin B and Oral Triazole (predominantly oral Posaconazole) was the most common medical treatment offered to all patients with COVID associated mucorpatient. Functional endoscopic sinus surgery was done on 93% cases followed by Modified Denker’s procedure was done in 12% cases. Conclusion: In our study, mucormycosis appears to be associated with COVID-19, diabetes, and use of corticosteroids. Full vaccination with COVID-19 vaccines, judicious use of corticosteroids in patients with COVID-19 and strict control of blood glucose level along with timely and proper management is highly recommended to reduce the incidence of fatal mucormycosis.
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spelling doaj.art-b66e0f08f8ba4ef786e87e46756ff7282022-12-22T03:03:58ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762022-05-01135712https://doi.org/10.3126/ajms.v13i5.43940A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)Pallavi Indurkar 0https://orcid.org/0000-0001-8589-2893Aashutosh Asati 1https://orcid.org/0000-0003-3028-7068Yasmeen Siddiqui 2https://orcid.org/0000-0002-0816-673XShubhangi Nayak 3https://orcid.org/0000-0001-9615-575XManoj Indurkar 4https://orcid.org/0000-0001-6986-282XAssistant Professor, Department of ENT, Shyam Shah Medical College, Rewa, Madhya Pradesh, IndiaAssistant Professor, Department of TB and Chest Diseases, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Assistant Professor, Department of ENT, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Assistant Professor, Department of Community Medicine, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Professor, Department of Medicine, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Background: Second wave of coronavirus disease 2019 (Covid-19) pandemic has been particularly devastating in India. COVID-19 and mucormycosis (also known as black fungus) are causing comorbid conditions to worsen the extent of infection and mortality rates especially in India. Mucormycosis can involve nose, sinuses, orbit, central nervous system, lung (pulmonary), gastrointestinal tract any many other organs, but rhino orbital cerebral mucormycosis is the most common variety seen. Rapidity of dissemination of mucormycosis is an extraordinary phenomenon and a delay in the diagnosis could be fatal. Aims and Objectives: The objective of this study is to document the clinical features, radiological extent, risk factors, management, and outcome of mucormycosis. Materials and Methods: The study was retrospective observational study. Eighty-two mucormycosis patients admitted in SGMH Rewa were selected as study subjects. Data regarding clinical features, radiological extent, associated risk factors, comorbidities, management during hospital stay, and outcome of mucormycosis patients were collected on excel sheet and analyzed using appropriate statistical tests. Results: In our study, majority of the patients were unvaccinated (88%). Most common presenting complaint was nasal congestion with or without discharge in 78% patients followed by Facial swelling, visual disturbances, facial weakness, dental pain, etc. On CT or magnetic resonance imaging examination, all cases of mucormycosis had maxillary sinus (100%) involvement, followed by ethmoid (82%) and sphenoid (78%) sinuses. Diabetes mellitus was most common comorbidity seen in 52% cases. About 83% cases had history of receiving high dose steroid intravenously during management of COVID illness. Among study cases 72% patients have taken oxygen supplementation for more than 72 h, for COVID-19 pneumonia before hospitalization for mucormycosis. Therapy of Liposomal Amphotericin B and Oral Triazole (predominantly oral Posaconazole) was the most common medical treatment offered to all patients with COVID associated mucorpatient. Functional endoscopic sinus surgery was done on 93% cases followed by Modified Denker’s procedure was done in 12% cases. Conclusion: In our study, mucormycosis appears to be associated with COVID-19, diabetes, and use of corticosteroids. Full vaccination with COVID-19 vaccines, judicious use of corticosteroids in patients with COVID-19 and strict control of blood glucose level along with timely and proper management is highly recommended to reduce the incidence of fatal mucormycosis.https://www.nepjol.info/index.php/AJMS/article/view/43940mucormycosisdiabetes mellituscorticosteroidscovid-19
spellingShingle Pallavi Indurkar
Aashutosh Asati
Yasmeen Siddiqui
Shubhangi Nayak
Manoj Indurkar
A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
Asian Journal of Medical Sciences
mucormycosis
diabetes mellitus
corticosteroids
covid-19
title A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
title_full A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
title_fullStr A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
title_full_unstemmed A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
title_short A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
title_sort study on clinico radiological profile risk factors and management of mucormycosis during covid pandemic in rewa m p
topic mucormycosis
diabetes mellitus
corticosteroids
covid-19
url https://www.nepjol.info/index.php/AJMS/article/view/43940
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