tetano
Editor, Senior Moderator
PLoS One
. 2022 Aug 8;17(8):e0272042.
doi: 10.1371/journal.pone.0272042. eCollection 2022.
Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India
Manickam Ponnaiah[SUP] 1 [/SUP], Sivaraman Ganesan[SUP] 2 [/SUP], Tarun Bhatnagar[SUP] 1 [/SUP], Mahalakshmy Thulasingam[SUP] 2 [/SUP], Marie Gilbert Majella[SUP] 1 [/SUP], Mathan Karuppiah[SUP] 1 [/SUP], S A Rizwan[SUP] 1 [/SUP], Arun Alexander[SUP] 2 [/SUP], Sonali Sarkar[SUP] 2 [/SUP], Sitanshu Sekhar Kar[SUP] 2 [/SUP], Tamilarasu Kadhiravan[SUP] 2 [/SUP], Aparna Bhatnagar[SUP] 3 [/SUP], Prasanna Kumar S[SUP] 4 [/SUP], Vivekanandan M Pillai[SUP] 2 [/SUP], Pradeep Pankajakshan Nair[SUP] 2 [/SUP], Rahul Dhodapkar[SUP] 2 [/SUP], Pampa Ch Toi[SUP] 2 [/SUP], Rakesh Singh[SUP] 2 [/SUP], Nirupama Kasthuri[SUP] 2 [/SUP], Girish C P Kumar[SUP] 1 [/SUP], Saranya Jaisankar[SUP] 1 [/SUP], Vaibhav Saini[SUP] 5 [/SUP], Ankita Kankaria[SUP] 5 [/SUP], Anuradha Raj[SUP] 5 [/SUP], Amit Goyal[SUP] 6 [/SUP], Vidhu Sharma[SUP] 6 [/SUP], Satyendra Khichar[SUP] 6 [/SUP], Kapil Soni[SUP] 6 [/SUP], Mahendra Kumar Garg[SUP] 6 [/SUP], Kalaiselvi Selvaraj[SUP] 7 [/SUP], ShriKrishna B H[SUP] 7 [/SUP], Kranti Bhavana[SUP] 8 [/SUP], Bhartendu Bharti[SUP] 8 [/SUP], C M Singh[SUP] 8 [/SUP], Neha Chaudhary[SUP] 8 [/SUP], Vijayaravindh R[SUP] 9 [/SUP], Gopinath K[SUP] 9 [/SUP], Karthikeyan Palaninathan[SUP] 9 [/SUP], Simmi Dube[SUP] 10 [/SUP], Rita Singh Saxena[SUP] 10 [/SUP], Nikhil Gupta[SUP] 10 [/SUP], A Rathinavel[SUP] 11 [/SUP], S Priya[SUP] 11 [/SUP], Arulsundareshkumar[SUP] 11 [/SUP], Shama A Bellad[SUP] 12 [/SUP], Avinash Kavi[SUP] 12 [/SUP], Anilkumar S Harugop[SUP] 12 [/SUP], Kailesh Pujary[SUP] 13 [/SUP], Kirthinath Ballala[SUP] 13 [/SUP], Sneha Deepak Mallya[SUP] 13 [/SUP], Hanumanth M Prasad[SUP] 14 [/SUP], D Ravi[SUP] 14 [/SUP], N K Balaji[SUP] 14 [/SUP], Raghuraj Hegde[SUP] 15 [/SUP], Neha Mishra[SUP] 15 [/SUP], Shalina Ray[SUP] 15 [/SUP], S Karthikeyan[SUP] 16 [/SUP], Sudha Ramalingam[SUP] 16 [/SUP], A Murali[SUP] 16 [/SUP], Sudhakar Vaidya[SUP] 17 [/SUP], Mohit Samadhiya[SUP] 17 [/SUP], Dhaval Bhojani[SUP] 17 [/SUP], Somu Lakshmanan[SUP] 4 [/SUP], Sudagar R B Singh[SUP] 4 [/SUP], Nataraj Pillai[SUP] 18 [/SUP], P Deepthi[SUP] 18 [/SUP], K Banumathi[SUP] 18 [/SUP], V Sumathi[SUP] 19 [/SUP], D Ramesh[SUP] 19 [/SUP], Sonam Poonam Nissar[SUP] 19 [/SUP], Khushnood M Sheikh[SUP] 20 [/SUP], Manisha N Patel[SUP] 20 [/SUP], Vipul Shristava[SUP] 20 [/SUP], Suresh S Kumar[SUP] 21 [/SUP], K Shantaraman[SUP] 21 [/SUP], Rajkamal D Pandian[SUP] 21 [/SUP], Manoj Murhekar[SUP] 1 [/SUP], Rakesh Aggarwal[SUP] 2 [/SUP]
Affiliations
Abstract
Background: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India.
Methods: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model.
Results: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM.
Conclusions: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.
. 2022 Aug 8;17(8):e0272042.
doi: 10.1371/journal.pone.0272042. eCollection 2022.
Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India
Manickam Ponnaiah[SUP] 1 [/SUP], Sivaraman Ganesan[SUP] 2 [/SUP], Tarun Bhatnagar[SUP] 1 [/SUP], Mahalakshmy Thulasingam[SUP] 2 [/SUP], Marie Gilbert Majella[SUP] 1 [/SUP], Mathan Karuppiah[SUP] 1 [/SUP], S A Rizwan[SUP] 1 [/SUP], Arun Alexander[SUP] 2 [/SUP], Sonali Sarkar[SUP] 2 [/SUP], Sitanshu Sekhar Kar[SUP] 2 [/SUP], Tamilarasu Kadhiravan[SUP] 2 [/SUP], Aparna Bhatnagar[SUP] 3 [/SUP], Prasanna Kumar S[SUP] 4 [/SUP], Vivekanandan M Pillai[SUP] 2 [/SUP], Pradeep Pankajakshan Nair[SUP] 2 [/SUP], Rahul Dhodapkar[SUP] 2 [/SUP], Pampa Ch Toi[SUP] 2 [/SUP], Rakesh Singh[SUP] 2 [/SUP], Nirupama Kasthuri[SUP] 2 [/SUP], Girish C P Kumar[SUP] 1 [/SUP], Saranya Jaisankar[SUP] 1 [/SUP], Vaibhav Saini[SUP] 5 [/SUP], Ankita Kankaria[SUP] 5 [/SUP], Anuradha Raj[SUP] 5 [/SUP], Amit Goyal[SUP] 6 [/SUP], Vidhu Sharma[SUP] 6 [/SUP], Satyendra Khichar[SUP] 6 [/SUP], Kapil Soni[SUP] 6 [/SUP], Mahendra Kumar Garg[SUP] 6 [/SUP], Kalaiselvi Selvaraj[SUP] 7 [/SUP], ShriKrishna B H[SUP] 7 [/SUP], Kranti Bhavana[SUP] 8 [/SUP], Bhartendu Bharti[SUP] 8 [/SUP], C M Singh[SUP] 8 [/SUP], Neha Chaudhary[SUP] 8 [/SUP], Vijayaravindh R[SUP] 9 [/SUP], Gopinath K[SUP] 9 [/SUP], Karthikeyan Palaninathan[SUP] 9 [/SUP], Simmi Dube[SUP] 10 [/SUP], Rita Singh Saxena[SUP] 10 [/SUP], Nikhil Gupta[SUP] 10 [/SUP], A Rathinavel[SUP] 11 [/SUP], S Priya[SUP] 11 [/SUP], Arulsundareshkumar[SUP] 11 [/SUP], Shama A Bellad[SUP] 12 [/SUP], Avinash Kavi[SUP] 12 [/SUP], Anilkumar S Harugop[SUP] 12 [/SUP], Kailesh Pujary[SUP] 13 [/SUP], Kirthinath Ballala[SUP] 13 [/SUP], Sneha Deepak Mallya[SUP] 13 [/SUP], Hanumanth M Prasad[SUP] 14 [/SUP], D Ravi[SUP] 14 [/SUP], N K Balaji[SUP] 14 [/SUP], Raghuraj Hegde[SUP] 15 [/SUP], Neha Mishra[SUP] 15 [/SUP], Shalina Ray[SUP] 15 [/SUP], S Karthikeyan[SUP] 16 [/SUP], Sudha Ramalingam[SUP] 16 [/SUP], A Murali[SUP] 16 [/SUP], Sudhakar Vaidya[SUP] 17 [/SUP], Mohit Samadhiya[SUP] 17 [/SUP], Dhaval Bhojani[SUP] 17 [/SUP], Somu Lakshmanan[SUP] 4 [/SUP], Sudagar R B Singh[SUP] 4 [/SUP], Nataraj Pillai[SUP] 18 [/SUP], P Deepthi[SUP] 18 [/SUP], K Banumathi[SUP] 18 [/SUP], V Sumathi[SUP] 19 [/SUP], D Ramesh[SUP] 19 [/SUP], Sonam Poonam Nissar[SUP] 19 [/SUP], Khushnood M Sheikh[SUP] 20 [/SUP], Manisha N Patel[SUP] 20 [/SUP], Vipul Shristava[SUP] 20 [/SUP], Suresh S Kumar[SUP] 21 [/SUP], K Shantaraman[SUP] 21 [/SUP], Rajkamal D Pandian[SUP] 21 [/SUP], Manoj Murhekar[SUP] 1 [/SUP], Rakesh Aggarwal[SUP] 2 [/SUP]
Affiliations
- PMID: 35939442
- DOI: 10.1371/journal.pone.0272042
Abstract
Background: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India.
Methods: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model.
Results: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM.
Conclusions: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.