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Clinical Trial
. 2021 Jul-Aug;15(4):102196.
doi: 10.1016/j.dsx.2021.102196. Epub 2021 Jul 3.

Diabetes, COVID 19 and mucormycosis: Clinical spectrum and outcome in a tertiary care medical center in Western India

Yogendra Mishra  1 , Manoj Prashar  2 , Deepak Sharma  3 , Akash  4 , V Pravin Kumar  5 , T V S V G K Tilak  3
Affiliations
Clinical Trial

Diabetes, COVID 19 and mucormycosis: Clinical spectrum and outcome in a tertiary care medical center in Western India

Yogendra Mishra et al. Diabetes Metab Syndr. 2021 Jul-Aug.

Abstract

Aims: Diabetes Mellitus predisposes patients to invasive fungal infections. There has been a recent surge of Mucormycosis with COVID 19 infection particularly in patients with diabetes. This study aims to study the clinical spectrum of CAM (COVID -associated Mucormycosis) with diabetes and subsequent outcomes.

Material and methods: This was a descriptive study conducted at a single COVID Care Centre in India in patients with COVID Associated Mucormycosis from April 12, 2021 to May 31, 2021.

Results: Among 953 hospitalized patients with COVID 19 infection, 32 patients had CAM with an incidence of 3.36%. In patients with CAM, 87.5% had Diabetes Mellitus as the most common co-morbidity. The majority of the patients had poor glycemic control with a mean HbA1c of 9.06%. Out of the total study population, 93% had prior exposure to high dose corticosteroids. During the study period, 12.5% patients of CAM did not survive.

Conclusion: Mucormycosis is an angioinvasive fungal infection with high mortality. The disease has surged in COVID 19 pandemic due to uncontrolled diabetes and improper corticosteroid use.

Keywords: COVID-19; Diabetes; Mucormycosis.

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Conflict of interest statement

Declaration of competing interest The Authors declare there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Box and whisker plot showing relationship of total leucocyte count with outcome in patients with Covid-Associated Mucormycosis.
Fig. 2
Fig. 2
Clinical spectrum of Covid -Associated Mucormycosis (A) Right Orbital cellulitis (B) Palatal Mucormycosis (C) Cutaneous Mucormycosis involving face in our patients.
Fig. 3
Fig. 3
Radiological images of Rhino-orbital Mucormycosis (A) MRI Orbit suggestive of right orbital involvement. (B&C) Commuted Tomography of Paranasal sinuses suggestive of right maxillary sinusitis.
Fig. 4
Fig. 4
Histopathology of post-operation specimen with Hematoxylin &Eosin staining showing(A) Broad branched aseptate fungal hyphae suggestive of Mucormycosis (B) Fungal invasion into the vessel wall.
See this image and copyright information in PMC

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