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. 2022 Oct;74(Suppl 2):3151-3157.
doi: 10.1007/s12070-021-02875-4. Epub 2021 Sep 25.

Predisposing factors of rhino-orbital-cerebral mucormycosis in patients with COVID 19 infection

Pradeep Pradhan  1 , Zaid Shaikh  1 , Abhijeet Mishra  1 , C Preetam  1 , Pradipta Kumar Parida  1 , Sourav Sarkar  1 , Dillip Kumar Samal  1 , Anindya Nayak  1 , Srinivas Chadaram  1 , Krishna Kinkar Das  1 , Swagata Chakraborty  1 , Prity Sharma  1 , K V Aswathi  1 , K Vinusree  1 , Yash Mittal  1 , Kalyana Sundaram  1 , Anurita Swarup  1 , Asutosh Adhikari  1 , Swathi Chenniappan  1 , Anwer Shah  1
Affiliations

Predisposing factors of rhino-orbital-cerebral mucormycosis in patients with COVID 19 infection

Pradeep Pradhan et al. Indian J Otolaryngol Head Neck Surg. 2022 Oct.

Abstract

The predisposing factors of invasive fungal disease in COVID 19 infection are still debatable because of the limited human understanding of the virus with the current literature. In this study, we have tried to correlate the various predisposing factors influencing the clinical profile and treatment outcomes in patients with covid associated mucormycosis (CAM). It is a retrospective analysis of cases of CAM during the second wave of COVID 19 infection, which was managed in the department of Otorhinolaryngology from Dec 1, 2020, to June 10, 2021. The detailed clinical, radiological and management of patients with CAM were collected, recorded, evaluated and correlated with the predisposing factors. Of the total, 46 patients, 44(95.65%) were diabetic and 41 patients had a previous history of steroid intake. When clinical parameters were compared between blood sugar < 200 mg/dl and > 200 mg/dl, the old and newly diagnosed diabetes mellitus in patients with CAM, there was no significant differences in any of the above clinical parameters (p > 0.05), except the hospital stay (p = 0,004). Steroid intake in patients with coexisting DM associated with CAM is considered the most important factor for the development of the CAM. There was are no significant difference in any of the clinical/treatment outcomes in patients with CAM with respect to the initial blood sugar, except for the hospital stay. A large sample size with a long-term follow-up period may be needed for a better understanding of common predisposing factors for the development of CAM.

Keywords: COVID 19; Mucormycosis; Predisposing factors.

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Conflict of interest statement

Conflicts of interestDisclosure of potential conflicts of interest: There are no conflicts of interest among the authors.

Figures

Fig. 1
Fig. 1
Contrast-enhanced MRI, T1-weighted (A coronal cut, B axial cut) shows the contrast-enhanced shadow indicating the involvement of the intraconal compartment of the right orbit with involvement of maxillary and anterior ethmoid sinuses
Fig. 2
Fig. 2
Contrast enhanced MRI, T2 weighted (A, axial cut) shows hyperintense shadow involving left paranasal sinuses with a cerebral abscess in the left temporal lobe. B, T-1weighted(coronal cuts) shows right sinusitis with right frontal abscess, extending to the parietal brain
Fig. 3
Fig. 3
Non-contrast MRI scan(A, axial cut) shows erosion of anterior arch of the mandible, B. (coronal cut) shows complete erosion of anterior table with sequestrum in the frontal sinus
Fig. 4
Fig. 4
Bar diagram which shows the clinical symptoms of patients with CAM when presented to the outpatient department
Fig. 5
Fig. 5
Demonstrate the treatment protocol followed for patients with CAM
See this image and copyright information in PMC

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