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Rhino-orbital mucormycosis following COVID-19 in previously non-diabetic, immunocompetent patients.
Nair, Akshay Gopinathan; Adulkar, Namrata G; D'Cunha, Lynn; Rao, Priyanka R; Bradoo, Renuka A; Bapaye, Maneesh M; Kothari, Abhishek; Dave, Tarjani V; Shinde, Chhaya A.
  • Nair AG; Department of Ophthalmology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai, India.
  • Adulkar NG; Ophthalmic Plastic Surgery and Ocular Oncology Services, Aditya Jyot Eye Hospital, Wadala, Mumbai, India.
  • D'Cunha L; Ophthalmic Plastic Surgery and Ocular Oncology Services, Advanced Eye Hospital & Institute, Navi Mumbai, India.
  • Rao PR; Oculoplastics and Orbital Surgery, R Jhunjhunwala Sankara Eye Hospital, Panvel, India.
  • Bradoo RA; Sunayan Eye Care and Aesthetic Clinic, Pune, India.
  • Bapaye MM; Department of Ophthalmology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai, India.
  • Kothari A; Department of Ophthalmology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai, India.
  • Dave TV; Department of Otorhinolaryngology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai, India.
  • Shinde CA; Bapaye Eye Hospital, Nashik, India.
Orbit ; 40(6): 499-504, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1334049
ABSTRACT

PURPOSE:

To report a series of 13 immunocompetent patients who developed new-onset uncontrolled diabetes mellitus (DM) following COVID-19 infection and presented as rhino-orbital mucormycosis (ROM).

METHOD:

Retrospective study.

RESULTS:

A total of 127 patients of COVID-19 Associated Mucormycosis (CAM) were evaluated at four centres in India. All patients underwent endoscopic sinus debridement surgery and received systemic amphotericin-B therapy. Five patients (5/13; 38.4%) received retrobulbar amphotericin-B injections. Orbital exenteration was performed in advanced orbital involvement or progression of orbital disease in spite of maximal medical therapy. In his cohort, 13/127 (10.2%) patients presented with new onset DM, where one patient had bilateral disease. The mean age was 35.9 years (range 20-51 years) and the mean duration from diagnosis of COVID-19 to the diagnosis of mucormycosis was 14.2 days. While 7/13 (53.8%) of the patients received systemic corticosteroids during the course of their treatment for COVID-19, six patients received no steroids or immunomodulators. The mean follow-up period was 9.2 weeks (range 3-18 weeks) following discharge. Life salvage was possible in 100% of the cases. While overall globe salvage was possible in 42.8% (6/14 eyes), the globe could be preserved in 4/5 patients who received retrobulbar amphotericin-B injections.

CONCLUSIONS:

Those involved in the care of COVID-19 patients should be aware about the possibility of recent-onset DM, even in patients without a history of corticosteroid therapy. Rarely, recent-onset DM following COVID-19 may present as rhino-orbital mucormycosis, which requires aggressive surgical and medical intervention.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / Eye Infections, Fungal / COVID-19 / Mucormycosis Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Orbit Year: 2021 Document Type: Article Affiliation country: 01676830.2021.1960382

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / Eye Infections, Fungal / COVID-19 / Mucormycosis Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Orbit Year: 2021 Document Type: Article Affiliation country: 01676830.2021.1960382