COVID-19-associated mucormycosis presenting to the Emergency Department-an observational study of 70 patients

Mucormycosis (MM) is a deadly opportunistic fungal infection and a large surge in COVID-19-associated mucormycosis (CAM) is occurring in India. Our aim was to delineate the clinico-epidemiological profile and identify risk factors of CAM patients presenting to the Emergency Department (ED). This was...

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Bibliographic Details
Published in:	QJM : An International Journal of Medicine 2021-11, Vol.114 (7), p.464-470
Main Authors:	Ramaswami, A, Sahu, A K, Kumar, A, Suresh, S, Nair, A, Gupta, D, Chouhan, R, Bhat, R, Mathew, R, Majeed, J A, Aggarwal, P, Nayer, J, Ekka, M, Thakar, A, Singh, G, Xess, I, Wig, N
Format:	Article
Language:	eng
Subjects:	Adult COVID-19 Emergency Service, Hospital Female Humans Male Mucormycosis - diagnosis Mucormycosis - epidemiology Original Paper Retrospective Studies SARS-CoV-2
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Summary:	Mucormycosis (MM) is a deadly opportunistic fungal infection and a large surge in COVID-19-associated mucormycosis (CAM) is occurring in India. Our aim was to delineate the clinico-epidemiological profile and identify risk factors of CAM patients presenting to the Emergency Department (ED). This was a retrospective, single-centre, observational study. We included patients who presented with clinical features or diagnosed MM and who were previously treated for COVID-19 in last 3 months of presentation (recent COVID-19) or currently being treated for COVID-19 (active COVID-19). Information regarding clinical features of CAM, possible risk factors, examination findings, diagnostic workup including imaging and treatment details were collected. Seventy CAM patients (median age: 44.5 years, 60% males) with active (75.7%) or recent COVID-19 (24.3%) who presented to the ED in between 6 May 2021 and 1 June 2021, were included. A median duration of 20 days (interquartile range: 13.5-25) was present between the onset of COVID-19 symptoms and the onset of CAM symptoms. Ninety-three percent patients had at least one risk factor. Most common risk factors were diabetes mellitus (70%) and steroid use for COVID-19 disease (70%). After clinical, microbiological and radiological workup, final diagnosis of rhino-orbital CAM was made in most patients (68.6%). Systemic antifungals were started in the ED and urgent surgical debridement was planned. COVID-19 infection along with its medical management have increased patient susceptibility to MM.
ISSN:	1460-2725 1460-2393