Clinico-radiological Spectrum of COVID-19 Associated Rhino-cerebral Mucormycosis: A Retrospective Cohort Study from a Tertiary Care Hospital
Journal of Clinical and Diagnostic Research
; 16(7):TC01-TC05, 2022.
Article
in English
| EMBASE | ID: covidwho-1957580
ABSTRACT
Introduction:
Rhino-cerebral Mucormycosis (RCM), in the pre-Coronavirus Disease-2019 (COVID-19) era, was thought to be solely associated with an immunocompromised state. However,anunforeseenoutbreakinthenumberofmucormycosis cases was seen with the increase in Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection.Aim:
To study and investigate the clinical characteristics, imaging findings, associated risk factors, and clinical outcomes in COVID-19 associated mucormycosis. Materials andMethods:
A retrospective cohort study was conducted comprising 480 cases of COVID-19 associated mucormycosis who presented to the institution between April 2020 and September 2020. The clinical and radiological data were studied and analysed.results:
Out of a total of 480 cases, 443 (92.29%) were found to suffering from diabetes mellitus and 392 patients (81.66%) had a history of steroids intake in the studied population. Facial or per orbital swelling followed by pain were the most frequent presenting complaints found in 188 (39.16%) and 162 (33.75%) patients, respectively. Nasal septum and middle turbinate were the most common sites of disease involvement on nasal endoscopic examination. On radiological imaging, maxillary (438;91.25%) was the most commonly involved sinus followed by ethmoids (395;82.29%). Premaxillary/retroantral fat and orbits were the most common sites of extra sinonasal spread of infection found in 278 (57.91%) and 244 (50.83%) patients, respectively. About 238 (49.58%) patients showed bony erosion and dehiscence. Intracranial complications were seen in 73 (15.21%) patients. Glycated Haemoglobin (HbA1c) levels showed significant value with higher disease staging. Oxygen supplementation was frequently associated with extrasinus spread of infection. A total of 44 (9.17%) patients succumbed to death despite aggressive antifungal treatment.conclusion:
COVID-19 associated RCM shows frequent and extensive spread to extrasinus regions, especially with uncontrolled diabetes mellitus, steroid administration, and oxygen supplementation. High clinical suspicion, early imaging, and prompt institution of antifungal therapy can aid in reducing mortality rate.
adult; antifungal therapy; article; clinical feature; clinical outcome; cohort analysis; complication; coronavirus disease 2019; diabetes mellitus; drug therapy; endoscopy; erosion; ethmoid bone; face; female; genetic susceptibility; human; major clinical study; male; maxilla; mortality rate; mucormycosis; nose septum; nuclear magnetic resonance imaging; orbit; orbit tumor; outcome assessment; oxygen therapy; pain; retrospective study; risk factor; tertiary care center; turbinate; hemoglobin A1c; steroid
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Language:
English
Journal:
Journal of Clinical and Diagnostic Research
Year:
2022
Document Type:
Article
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