Mucormycosis in COVID: A pandemic induced epidemic in World's diabetic capital

ABSTRACT

Background: Mucormycosis is a rare disease of immunocompromised adults largely restricted to the diabetic community with uncontrolled hyperglycaemia. In the second wave of Covid, in multiple cities over the Indian Peninsula, this much dreaded “black fungus” has afflicted many individuals who suffered from covid or were recovering from it. Aim: To establish the risk factors, clinical presentation, diagnostic sensitivities, radiological survey of different types of mucormycosis in SARS Cov 2 patients. Methods: Seventeen patients with covid infection admitted in tertiary care hospital with diagnosed mucormycosis between Nov 2020 to June 2021 via histopathological or culture confirmation. This is a cross-sectional observational study where detailed assessment of clinical profile, biochemical markers and sensitivities of diagnostic procedures was done. The data then collected and was made into a master chart and subjected to statistical analysis. Fischer exact test was used for statistical anaylsis. Result:In total of 17 patients,mean blood glucose levels were compared at the onset of symptoms of covid and mucormycosis werestatistically significant with (P=0.001). Out of 17 patients, 11 were rhino-orbital mucormycosis, four had rhino-orbito-cerebral mucormycosis and 2 had pulmonary mucormycosis.HbA1c >8 had significant correlation(P=0.009) with rhino-orbital and rhino-orbito-cerebral mucormycosis whilehigher total dosage of steroids was associated with pulmonary mucormycosis (P= 0.015. Sensitivity of culture was 64.7% in our study while histopathology was considered gold standard. Conclusion: Our study shows strong correlation between the long term as well as short term glycaemic control with the onset of rhino-orbital mucormycosis while dosage and duration of steroids with pulmonary mucormycosis.