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Mucormycosis in COVID-19 - Evaluation of associated risk factors at a tertiary care centre.

Pragathi Kottapalli, Srinivas Kishore Sistla, SivaRam Nunna, Naveen Chander Reddy Podduturi, Sadhana Yelamanchili Veturi, Naveen Admala, Aswini Deborah.




Abstract
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Aim: India has reported a recent surge in Mucormycosis cases. Prevention of COVID-19 associated Mucormycosis needs to focus on aiming for better glycemic control in COVID-19 patients and monitoring the use of systemic corticosteroids in treating severe cases. This study is an attempt to evaluate various patient characteristics that could contribute to Mucormycosis among COVID and post COVID patients.
Materials and Methods: A retrospective observational study was carried out at a tertiary Care Hospital during April 2021–June 2021. After obtaining approval from Institutional Ethics committee, various demographic and clinical details of all patients, such as diabetes mellitus, use of steroids in COVID-19 treatment, use of immunosuppressant drugs, oxygen therapy etc., were noted. All Mucormycosis patients were treated with Amphotericin B and aggressive surgical treatment.
Results: In the present study, majority of the patients who developed COVID associated Mucormycosis were treated in Private Hospitals (65, 62.5 %) for COVID -19 disease . About 78.89 % of Mucormycosis patients were males. In majority of the patient’s onset of symptoms of Mucormycosis was seen during the first week (56 %).Most patients were between 51-60 years (32.1 %). Among risk factors, 91.7 % had COVID-19 infection, 90.47% had received steroids, 80 % had diabetes mellitus and 47.11 % had received oxygen. About 37 % of patients presented in stage III and 35 % presented in stage I and II. In our study mortality was very less compared to other studies ( 12.35 %.).
Conclusion: There is a complex association between COVID -19 and Mucormycosis.The main predisposing factor was use of steroids during the treatment of COVID-19 which led to uncontrolled diabetes mellitus predisposing to Mucormycosis.

Key words: COVID – 19, Mucormycosis, Rhino Orbital Cerebral Mucormycosis, Diabetes






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