Clinical Outcomes in COVID-19 Associated Mucormycosis
Ravishankar C, Ashwini Godse, Pruthvi R Shivalingaiah
Keywords :
Black fungus, COVID-19-associated mucormycosis, Mucormycosis
Citation Information :
C R, Godse A, Shivalingaiah PR. Clinical Outcomes in COVID-19 Associated Mucormycosis. Int J Otorhinolaryngol Clin 2024; 16 (3):140-145.
Aim: Mucormycosis is an acute, invasive fungal infection with high morbidity and mortality. In India, there was a surge in COVID-19 associated mucormycosis (CAM) cases in the second wave of COVID-19 pandemic. This study aimed to study the various risk factors associated with the development of CAM, and the clinical outcomes of the treatment.
Materials and methods: A retrospective descriptive study was conducted at BLCH, Bengaluru, between May and December 2021. A total of 315 post-COVID reverse transcription-polymerase chain reaction (RTPCR) negative CAM patients were included in the study. The clinical profile of these patients was studied. Patients were started on IV antifungals at the earliest followed by surgical debridement. Clinical outcomes were measured based on the following parameters; preservation of the globe in the diseased eye, visual acuity (pre- and post-treatment), overall survival, and morbidity caused by debridement, and its rehabilitation.
Results: There are 243 male and 72 female patients. Diabetes mellitus was found in 275 patients with poor glycemic control. Nasal obstruction with headache and facial pain were the commonest symptoms. Orbital exenteration was done in 21 cases. The final visual acuity of perception of light (PL) positive was achieved in 152 patients. There are 73 patients who succumbed to the disease. About 6 patients who underwent primary surgery at our center had a recurrence of the disease.
Conclusions: COVID-19-associated CAM needs to be treated aggressively by a multidisciplinary approach. Early initiation of treatment with intravenous antifungals and surgical debridement reduces the morbidity and mortality.
Clinical significance: Early initiation of treatment with intravenous antifungals and surgical debridement reduces the morbidity and mortality in CAM patients.
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