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Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India.
Ponnaiah, Manickam; Ganesan, Sivaraman; Bhatnagar, Tarun; Thulasingam, Mahalakshmy; Majella, Marie Gilbert; Karuppiah, Mathan; Rizwan, S A; Alexander, Arun; Sarkar, Sonali; Kar, Sitanshu Sekhar; Kadhiravan, Tamilarasu; Bhatnagar, Aparna; S, Prasanna Kumar; Pillai, Vivekanandan M; Nair, Pradeep Pankajakshan; Dhodapkar, Rahul; Ch Toi, Pampa; Singh, Rakesh; Kasthuri, Nirupama; Kumar, Girish C P; Jaisankar, Saranya; Saini, Vaibhav; Kankaria, Ankita; Raj, Anuradha; Goyal, Amit; Sharma, Vidhu; Khichar, Satyendra; Soni, Kapil; Garg, Mahendra Kumar; Selvaraj, Kalaiselvi; B H, ShriKrishna; Bhavana, Kranti; Bharti, Bhartendu; Singh, C M; Chaudhary, Neha; R, Vijayaravindh; K, Gopinath; Palaninathan, Karthikeyan; Dube, Simmi; Saxena, Rita Singh; Gupta, Nikhil; Rathinavel, A; Priya, S; Bellad, Shama A; Kavi, Avinash; Harugop, Anilkumar S; Pujary, Kailesh; Ballala, Kirthinath; Mallya, Sneha Deepak; Prasad, Hanumanth M.
  • Ponnaiah M; ICMR-National Institute of Epidemiology, Chennai, India.
  • Ganesan S; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Bhatnagar T; ICMR-National Institute of Epidemiology, Chennai, India.
  • Thulasingam M; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Majella MG; ICMR-National Institute of Epidemiology, Chennai, India.
  • Karuppiah M; ICMR-National Institute of Epidemiology, Chennai, India.
  • Rizwan SA; ICMR-National Institute of Epidemiology, Chennai, India.
  • Alexander A; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Sarkar S; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Kar SS; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Kadhiravan T; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Bhatnagar A; Apollo Specialty Hospitals, Vanagaram & Billroth Hospital, Shenoy Nagar, Chennai, India.
  • S PK; Sri Ramachandra Medical Centre, Chennai, India.
  • Pillai VM; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Nair PP; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Dhodapkar R; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Ch Toi P; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Singh R; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Kasthuri N; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
  • Kumar GCP; ICMR-National Institute of Epidemiology, Chennai, India.
  • Jaisankar S; ICMR-National Institute of Epidemiology, Chennai, India.
  • Saini V; All India Institute of Medical Sciences, Bathinda, India.
  • Kankaria A; All India Institute of Medical Sciences, Bathinda, India.
  • Raj A; All India Institute of Medical Sciences, Bathinda, India.
  • Goyal A; All India Institute of Medical Sciences, Jodhpur, India.
  • Sharma V; All India Institute of Medical Sciences, Jodhpur, India.
  • Khichar S; All India Institute of Medical Sciences, Jodhpur, India.
  • Soni K; All India Institute of Medical Sciences, Jodhpur, India.
  • Garg MK; All India Institute of Medical Sciences, Jodhpur, India.
  • Selvaraj K; All India Institute of Medical Sciences, Nagpur, India.
  • B H S; All India Institute of Medical Sciences, Nagpur, India.
  • Bhavana K; All India Institute of Medical Sciences, Patna, India.
  • Bharti B; All India Institute of Medical Sciences, Patna, India.
  • Singh CM; All India Institute of Medical Sciences, Patna, India.
  • Chaudhary N; All India Institute of Medical Sciences, Patna, India.
  • R V; G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India.
  • K G; G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India.
  • Palaninathan K; G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India.
  • Dube S; Gandhi Medical College, Bhopal, India.
  • Saxena RS; Gandhi Medical College, Bhopal, India.
  • Gupta N; Gandhi Medical College, Bhopal, India.
  • Rathinavel A; Government Rajaji Hospital and Medical College, Madurai, India.
  • Priya S; Government Rajaji Hospital and Medical College, Madurai, India.
  • Arulsundareshkumar; Government Rajaji Hospital and Medical College, Madurai, India.
  • Bellad SA; Jawaharlal Nehru Medical College, Belagavi, India.
  • Kavi A; Jawaharlal Nehru Medical College, Belagavi, India.
  • Harugop AS; Jawaharlal Nehru Medical College, Belagavi, India.
  • Pujary K; Kasturba Medical College, Manipal, India.
  • Ballala K; Kasturba Medical College, Manipal, India.
  • Mallya SD; Kasturba Medical College, Manipal, India.
PLoS One ; 17(8): e0272042, 2022.
Article in English | MEDLINE | ID: covidwho-2079710
ABSTRACT

BACKGROUND:

In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India.

METHODS:

We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model.

RESULTS:

Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM.

CONCLUSIONS:

Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / Diabetes Mellitus / COVID-19 / Hyperglycemia / Mucormycosis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans / Middle aged Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0272042

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / Diabetes Mellitus / COVID-19 / Hyperglycemia / Mucormycosis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans / Middle aged Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0272042