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Journal of Acute Disease ; 11(4):156-160, 2022.
Article in English | EMBASE | ID: covidwho-2066826


Objective: To explore risk factors of mucormycosis in COVID-19 recovered patients. Methods: A total of 101 patients, who were diagnosed with mucormycosis after recovery from COVID-19 and admitted to the Indira Gandhi Institute of Medical Sciences, Patna, a tertiary care hospital in India, were included in the study. The presenting clinical features and associated risk factors were assessed and analyzed subsequently. Results: Of 101, 68 (67.3%) were males, and 33 (32.7%) were females. A total of 89 (88.1%) patients were between 46 and 65 years old. The most common subtypes were rhino-ocular (61.4%), followed by paranasal sinuses (16.8%), rhino-ocular cerebral (16.8%), ocular (3.0%), and pulmonary (2.0%). Diabetes mellitus was present in 71% of cases of mucormycosis as co-morbidities. A total of 76.2% of patients were given systemic corticosteroids in oral or intravenous form during COVID-19 treatment. Severe COVID-19 was present in 45.5% of patients with mucormycosis, while the moderate infection was present in 35.6% of mucormycosis. Most patients had gap between the onset of mucormycosis and COVID-19 <15 d. Conclusions: A lethal confluence of uncontrolled diabetes mellitus, corticosteroid usage, and COVID-19 could cause a dramatic rise in mucormycosis. So, clinicians must be aware of these risk factors in patients suffering as well as recovering from COVID-19 to prevent mucormycosis.

International Journal of Pharmaceutical Sciences Review and Research ; 75(1):199-203, 2022.
Article in English | EMBASE | ID: covidwho-1970067


In severe Covid-19 pneumonia, acute respiratory distress syndrome (ARDS) associated with cytokine storm is the leading cause of death. Tocilizumab was approved for chimeric antigen receptor T-cell therapy induced cytokine release syndrome and it may provide clinical benefit in these severe covid-19 pneumonia. In this retrospective cohort study, we evaluated patients with severe COVID-19 pneumonia admitted between May 2021 and June, 2021. Patients who were received tocilizumab during treatment, were enrolled for the study. Systemic steroids, hydroxychloroquine, and azithromycin were concomitantly used for the patients. The outcome was measured as an improvement in peripheral oxygen saturation by change in mode of oxygen therapy and improvement in laboratory parameters after tocilizumab administration. Out of 23 treated patients (18 Male, 5 Females), 19 patients received a single dose of tocilizumab and another four patients received two doses of it. Of these 23 patients, 3/3 with NRBM (non-rebreather mask) showed improvement and shifted to nasal cannula for oxygenation. 11/12 patients with NIV(non-invasive) showed improvement. 5/8 patients with invasive ventilation showed gradual improvement and shifted to NIV. A total of 4/23 (17%) patients didn’t show any improvement and died. Inflammatory markers like CRP, percentage of lymphocytes, and ferritin also showed significant improvement after administration of tocilizumab. Our study showed that in patients with severe COVID-19, tocilizumab was associated with significant improvement in clinical and laboratory parameters. These findings require further validation from ongoing clinical trials of Tocilizumab in COVID-19 patients.