PREVALENCE OF STROKE IN MUCORMYCOSIS PATIENTS WITH COVID-19 INFECTION IN INDIA

ABSTRACT

Background: During the second wave of COVID-19, India suffered from a catastrophic outburst of cases and rapid transmission of disease due to the highly infectious delta strain (B.1.617.2). Patients infected with this strain underwent prolonged hospitalisations, suffered from severe symptoms. A sudden surge of fungal infections, primarily Mucormycosis was observed. Methods: We conducted a case-control study to study various risk factors and form of intracranial involvement in cases of Mucormycosis. Results: Study included 121 patients in total;out of which 61 were Mucormycosis patients with prior COVID-19 infection. 30 out of 61 Mucormycosis patients had intracranial involvement with majority having stroke in the form of the either infarct (10 patients, 34%);or haemorrhage (3 patients, 10%) and thrombosis of artery involvement (8 patients, 29%). Other intracranial form of involvement was abscess (6 patients, 20%) and meningitis (2 patients, 7%). The most frequent type of infarcts were lacunar infarcts and the most common location of infarcts were middle cerebral artery (MCA) or anterior cerebral artery (ACA). Patients were treated with administration of Amphotericin B and Posaconazole. Telephonic follow-up was conducted after a time period of about 90 days and their health condition was recorded on basis of modified ranking scale (mRS). Out of the 30 Mucormycosis infection patients displaying the occurrence of stroke, 10 patients could not survive. q Conclusion: Intracranial Mucormycosis in COVID19 patients presenting with stroke were observed frequently and had mortality in about one-third cases.