COVID-19-associated mucormycosis: Preliminary report from a tertiary eye care centre

COVID-19-associated mucormycosis: Preliminary report from a tertiary eye care centre

Purpose: Mucormycosis is a life-threatening infection that has made sudden comeback in COVID-19 era. We conducted this study to determine demography, site of involvement, management, and outcome in these patients. Methods: All cases presenting with signs and symptoms of mucormycosis were thoroughly...

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Published in:Indian journal of ophthalmology Vol. 69; no. 12; pp. 3685 - 3689
Main Authors: Walia, Shweta, Bhaisare, Vijay, Rawat, Preeti, Kori, Neetu, Sharma, Manushree, Gupta, Niti, Urdhwareshwar, Shishir, Thakur, Sanchiyka, Arya, Niharika
Format: Journal Article
Language:English
Published: India Wolters Kluwer India Pvt. Ltd 01-12-2021
Medknow Publications and Media Pvt. Ltd
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer - Medknow
Wolters Kluwer Medknow Publications
Subjects:
Adult
amphotericin b
Antibiotics
Antifungal agents
Antifungal Agents - therapeutic use
Body fluids
Computed tomography
Coronaviruses
COVID-19
covid-19 (coronavirus disease in 2019)
Demography
Diabetes mellitus
Diagnosis
Epidemiology
Expedited Publications, Original
Fungal infections
Humans
immunosuppression
Magnetic resonance imaging
Male
Middle Aged
mucorales
mucormycetes
Mucormycosis
Mucormycosis - diagnosis
Mucormycosis - drug therapy
Mucormycosis - epidemiology
Neuroimaging
Orbital Diseases - diagnosis
Orbital Diseases - drug therapy
Orbital Diseases - epidemiology
Paranasal sinus
Patient outcomes
Patients
Risk factors
SARS-CoV-2
Statistics
Steroid hormones
India
Mucorales
Amphotericin B
Mucormycetes
immunosuppression
diabetes mellitus
COVID-19 (coronavirus disease in 2019)
mucormycosis
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Summary:Purpose: Mucormycosis is a life-threatening infection that has made sudden comeback in COVID-19 era. We conducted this study to determine demography, site of involvement, management, and outcome in these patients. Methods: All cases presenting with signs and symptoms of mucormycosis were thoroughly evaluated and confirmed diagnosis was made on demonstration of fungi in the tissue (or body fluids) either by direct microscopy and/or culture. Patients underwent computerized tomography scan for paranasal sinuses and magnetic resonance imaging scan with contrast orbit and brain to know extent of disease. Results: 540 proven cases of mucormycosis were included. Most common age group affected was 41-50 years with male preponderance (69%). Sinonasal was the most common site of involvement in mucormycosis (100%), followed by orbital (51.85%), cerebral (9.44%), cutaneous (1.85%), and pulmonary (0.18%). Most common presentation was periocular and facial swelling (28%). 97.96% patients had associated diabetes and 89.44% patients had history of COVID-19 with concurrent steroids use (84.85%), higher antibiotics (82.59%), oxygen therapy (52.40%), remdesivir (28.89%), and biological agents (2.56%). Duration from COVID-19 positivity to presentation of mucormycosis was 22.56 days, while 4.44% patients had coexisting COVID-19 with mucormycosis. The mortality rate was 9.25% (50/540). Conclusion: Timely diagnosis and appropriate management can ameliorate the consequences of mucormycosis. With the third wave of COVID-19 coming, epidemiological study to identify risk factors and possible management options can help physicians to develop the treatment strategy.
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ISSN:0301-4738
1998-3689
DOI:10.4103/ijo.IJO_2085_21