PREDICTORS OF MORTALITY IN PATIENTS WITH CONCOMITANT AND SEQUENTIAL COVID -19 ASSOCIATED MUCORMYCOSIS - A CROSS SECTIONAL STUDY IN A TERTIARY CARE CENTER

ABSTRACT

Introduction: Mortality rates for COVID-19-related mucormycosis vary greatly in reported studies. A systematic evaluation of 101 cases revealed a fatality rate of 30.7 percent. However, research on the determinants of death in COVID-19 associated mucormycosis is insufficient. The purpose of this study was to find out what factors contributed to in-hospital mortality in patients with COVID-19-related mucormycosis. Objectives: To study the the Clinical profile, Haematological,Biochemical and Radiological changes associated with mortality in patients with covid-19 associated mucormycosis. Methodology: In this single-center, observational study, 130 patients diagnosed with COVID-19 associated mucormycosis were recruited from a tertiary level intensive care unit from Bowring and Lady Curzon hospital, Bangalore, India. Results: Proportion of HTN, IHD, CKD and HIV was significantly more in non survivors compared to survivors. ICU admission and Oxygen requirement was scientifically higher in Non Survivors and had significant association with the outcome.. There was no significant difference in the levels of Hb, Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Platelets as p>0.05. Total count (17191±7764), ESR (57.6±12.4), CRP levels (199.0±69.5), and S.Ferritin (624.6±268.0) were significantly higher among the Non survivors. S.LDH (355.7±108.9), S.Free Iron (51.7±13.3), HBA1C (11.4±2.4), and S.Urea (36.9±35.3) were also found to be significantly higher among the non survivors. Conclusion: The current study highlights that a multidisciplinary approach in COVID-19 associated mucormycosis patients that includes timely and effective surgical debridement coupled with appropriate antifungal therapy and diligent sugar monitoring with intrahospital glycemic control may help to lower mortality.