Epidemiology of mucormycosis in post-COVID-19 patients treated in a tertiary care hospital, Visakhapatnam, Andhra Pradesh.

ABSTRACT

Introduction: Mucormycosis is associated with high mortality (45-90%) in average-income countries including India. Prevention of mucormycosis associated with coronavirus disease 2019 (COVID-19) or in patients recovering from COVID-19 needs a further understanding on epidemiology and underlying risk factors. Methodology: A hospital-based observational cross-sectional study was performed in a dermatology ward and neurosurgery ward, King George Hospital, Visakhapatnam (dedicated wards for mucormycosis), during May-June 2021 (60 days). After obtaining permission from Institutional Ethics Committee, the convenience sampling method was used and 115 cases admitted for mucormycosis who are post-COVID-19 patients were included in the study. Complete case history including the demographic data and signs and symptoms including the course of hospitalisation for COVID-19 was collected through a semi-structured questionnaire, and detailed clinical examination was conducted in relation with mucormycosis. Data collected were entered in MS excel 2010, and the analysis was performed using SPSS Version 21 for testing the level of significance with P < 0.05. Results: The majority of the patients belong to the 51-60 years (31.3%) age group, and 76.5% of them were females. Diabetes mellitus (76.5%) was the most common co-morbidity. Inhalational oxygen was given to 68 (59.1%) of patients. Pain in the eyes and nose was the most common complaint in patients with mucormycosis. Oxygen therapy during hospital admission and the presence of co-morbidities were significantly associated with findings of broad aseptate fungal hyphae on KOH mount. Conclusions: Prevention of COVID-19-associated mucormycosis needs to focus on aiming for appropriate oxygen therapy and better glycaemic control in COVID-19 patients and monitoring the use of systemic corticosteroids in treating severe cases.