tetano
Editor, Senior Moderator
Infection
. 2022 Aug 3.
doi: 10.1007/s15010-022-01891-y. Online ahead of print.
COVID-19 associated multisystemic mucormycosis from India: a multicentric retrospective study on clinical profile, predisposing factors, cumulative mortality and factors affecting outcome
Monalisa Sahu[SUP] 1 [/SUP], Milap Shah[SUP] 2 [/SUP], Venkateswara R Mallela[SUP] 3 [/SUP], Venkat Raman Kola[SUP] 4 [/SUP], Hari Kishan Boorugu[SUP] 3 [/SUP], Arshad A R Punjani[SUP] 3 [/SUP], R Vijay Kumar[SUP] 5 [/SUP], Sairaj Kumar[SUP] 5 [/SUP], Manusrut Manusrut[SUP] 5 [/SUP], S Ch Raghu Kumar[SUP] 5 [/SUP], Rajkumar Rathod[SUP] 6 [/SUP], Dilip M Babu[SUP] 7 [/SUP], Hari Kishan Gonuguntla[SUP] 8 [/SUP], Gopi Krishna Yedlapati[SUP] 8 [/SUP], Gangadhar Reddy Mallu[SUP] 8 [/SUP], Y Sai Reddy[SUP] 8 [/SUP], Vedire Vishnu Reddy[SUP] 9 [/SUP], Surendar Alwala[SUP] 10 [/SUP], Vijay Kumar Bongu[SUP] 3 [/SUP], A Kamalesh[SUP] 3 [/SUP], R N Komal Kumar[SUP] 11 [/SUP], Ganesh S Jaishetwar[SUP] 12 [/SUP], Ravi Shankar Bagapally[SUP] 13 [/SUP], Jammula S Srinivas[SUP] 14 [/SUP], Anandh Balasubramaniam[SUP] 15 [/SUP], Balasubramoniam Kavumkal Rajagopalan[SUP] 16 [/SUP], Bhulaxmi Pullikanti[SUP] 2 [/SUP], Swathi P Prakasham[SUP] 17 [/SUP], Pavani Nimmala[SUP] 17 [/SUP], Barla Nagaraju[SUP] 8 [/SUP], Pradipt R Sahoo[SUP] 5 [/SUP], MuCOVIDYH group
Collaborators, Affiliations
Abstract
Purpose: The clinical course of COVID-19 has been complicated by secondary infections, including bacterial and fungal infections. The rapid rise in the incidence of invasive mucormycosis in these patients is very much concerning. COVID-19-associated mucormycosis was detected in huge numbers during the second wave of the COVID-19 pandemic in India, with several predisposing factors indicated in its pathogenesis. This study aimed to evaluate the epidemiology, predisposing factor, cumulative mortality and factors affecting outcomes among the coronavirus disease COVID-19-associated mucormycosis (CAM).
Methods: A multicenter retrospective study across three tertiary health care centers in Southern part of India was conducted during April-June 2021.
Results: Among the 217 cases of CAM, mucormycosis affecting the nasal sinuses was the commonest, affecting 95 (44%) of the patients, orbital extension seen in 84 (38%), pulmonary (n = 25, 12%), gastrointestinal (n = 6, 3%), isolated cerebral (n = 2) and disseminated mucormycosis (n = 2). Diabetes mellitus, high-dose systemic steroids were the most common underlying disease among CAM patients. The mucormycosis-associated case-fatality at 6 weeks was 14%, cerebral or GI or disseminated mucormycosis had 9 times higher risk of death compared to other locations. Extensive surgical debridement along with sequential antifungal drug treatment improved the survival in mucormycosis patients.
Conclusion: Judicious and appropriate management of the predisposing factor and factors affecting mortality associated with CAM with multi-disciplinary approach and timely surgical and medical management can be much helpful in achieving a successful outcome.
Keywords: COVID-19; COVID-19 Associated Mucormycosis (CAM); Cerebral mucormycosis; Gastro-intestinal mucormycosis; Mucormycosis; Pulmonary mucormycosis; Sino-nasal mucormycosis.
. 2022 Aug 3.
doi: 10.1007/s15010-022-01891-y. Online ahead of print.
COVID-19 associated multisystemic mucormycosis from India: a multicentric retrospective study on clinical profile, predisposing factors, cumulative mortality and factors affecting outcome
Monalisa Sahu[SUP] 1 [/SUP], Milap Shah[SUP] 2 [/SUP], Venkateswara R Mallela[SUP] 3 [/SUP], Venkat Raman Kola[SUP] 4 [/SUP], Hari Kishan Boorugu[SUP] 3 [/SUP], Arshad A R Punjani[SUP] 3 [/SUP], R Vijay Kumar[SUP] 5 [/SUP], Sairaj Kumar[SUP] 5 [/SUP], Manusrut Manusrut[SUP] 5 [/SUP], S Ch Raghu Kumar[SUP] 5 [/SUP], Rajkumar Rathod[SUP] 6 [/SUP], Dilip M Babu[SUP] 7 [/SUP], Hari Kishan Gonuguntla[SUP] 8 [/SUP], Gopi Krishna Yedlapati[SUP] 8 [/SUP], Gangadhar Reddy Mallu[SUP] 8 [/SUP], Y Sai Reddy[SUP] 8 [/SUP], Vedire Vishnu Reddy[SUP] 9 [/SUP], Surendar Alwala[SUP] 10 [/SUP], Vijay Kumar Bongu[SUP] 3 [/SUP], A Kamalesh[SUP] 3 [/SUP], R N Komal Kumar[SUP] 11 [/SUP], Ganesh S Jaishetwar[SUP] 12 [/SUP], Ravi Shankar Bagapally[SUP] 13 [/SUP], Jammula S Srinivas[SUP] 14 [/SUP], Anandh Balasubramaniam[SUP] 15 [/SUP], Balasubramoniam Kavumkal Rajagopalan[SUP] 16 [/SUP], Bhulaxmi Pullikanti[SUP] 2 [/SUP], Swathi P Prakasham[SUP] 17 [/SUP], Pavani Nimmala[SUP] 17 [/SUP], Barla Nagaraju[SUP] 8 [/SUP], Pradipt R Sahoo[SUP] 5 [/SUP], MuCOVIDYH group
Collaborators, Affiliations
- PMID: 35922704
- DOI: 10.1007/s15010-022-01891-y
Abstract
Purpose: The clinical course of COVID-19 has been complicated by secondary infections, including bacterial and fungal infections. The rapid rise in the incidence of invasive mucormycosis in these patients is very much concerning. COVID-19-associated mucormycosis was detected in huge numbers during the second wave of the COVID-19 pandemic in India, with several predisposing factors indicated in its pathogenesis. This study aimed to evaluate the epidemiology, predisposing factor, cumulative mortality and factors affecting outcomes among the coronavirus disease COVID-19-associated mucormycosis (CAM).
Methods: A multicenter retrospective study across three tertiary health care centers in Southern part of India was conducted during April-June 2021.
Results: Among the 217 cases of CAM, mucormycosis affecting the nasal sinuses was the commonest, affecting 95 (44%) of the patients, orbital extension seen in 84 (38%), pulmonary (n = 25, 12%), gastrointestinal (n = 6, 3%), isolated cerebral (n = 2) and disseminated mucormycosis (n = 2). Diabetes mellitus, high-dose systemic steroids were the most common underlying disease among CAM patients. The mucormycosis-associated case-fatality at 6 weeks was 14%, cerebral or GI or disseminated mucormycosis had 9 times higher risk of death compared to other locations. Extensive surgical debridement along with sequential antifungal drug treatment improved the survival in mucormycosis patients.
Conclusion: Judicious and appropriate management of the predisposing factor and factors affecting mortality associated with CAM with multi-disciplinary approach and timely surgical and medical management can be much helpful in achieving a successful outcome.
Keywords: COVID-19; COVID-19 Associated Mucormycosis (CAM); Cerebral mucormycosis; Gastro-intestinal mucormycosis; Mucormycosis; Pulmonary mucormycosis; Sino-nasal mucormycosis.