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CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2022; 58(04): 210-219
DOI: 10.1055/s-0042-1757894
Original Article

Demographic and Clinical Profile of Patients Presenting with COVID-19-Associated Rhino-orbito-cerebral Mucormycosis at a Tertiary Care Center

Siddharth Madan
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Rekha Yadav
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Jolly Rohatgi
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Rahul Sharma
2   Department of Community Medicine, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Iffat Nasir
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Aarushi Saini
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Nampi Tadu
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Gopal Krushna Das
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Pramod Kumar Sahu
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Neelima Gupta
3   Department of ENT, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Nitika Beri
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
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Abstract

Objectives Individuals affected with rhino-orbito-cerebral mucormycosis (ROCM) associated with coronavirus disease 2019 (COVID-19) increased enormously in northern India during the second wave of the novel coronavirus disease. This study determined the demographic and clinical profile including the risk factors in patients presenting to a tertiary care hospital in northern India.

Materials and Methods This is a descriptive study involving patients admitted with COVID-19-associated ROCM and were managed from May 2021 to 20th July 2021.

Statistical Analysis The data was analyzed using SPSS (IBM SPSS Statistics 20, SPSS Inc., Chicago, Illinois, United States) software and Microsoft Excel (Version 16.49). The chi-squared and Fisher's exact tests were used to compare various outcomes. A p-value of less than or equal to 0.05 was considered to be statistically significant.

Results One hundred and seventeen (117) patients (males: 70 [59.8%], females:47 [40.2%]) with the average age of 51.85 ± 12.80 years presented with orbital involvement. Diabetes mellitus was noted in 100 (86.2%) patients. Of the available data from the records, oxygen supplementation for the management of COVID-19 was received by 37/108 (34.3%) patients for a median average duration of 11 days. Forty-eight patients of one-hundred-seventeen (60%) patients were treated with corticosteroids with a median duration of steroid administration being 10 days. The duration between onset of symptoms related to mucormycosis and diagnosis of COVID-19 was 0 to 75 days for 48 patients. Intravenous amphotericin B was administered in all cases. External sinonasal debridement was performed in 90 of 114 (78.9%) patients, retrobulbar amphotericin B injection was administered in 56 of 117 (47.9%), and orbital exenteration was performed in 17 of 117 (14.5%) of cases.

Conclusion Administration of corticosteroids and diabetes mellitus seem to be the major underlying causes for the development of COVID-19-associated ROCM. Prompt diagnosis and multidisciplinary management approach are essential for a reduction in mortality.

Keywords

ROCM - COVID-19 - orbital mucormycosis - orbital exenteration - diabetes mellitus - corticosteroids

Note

Informed consent was taken from the patient for inclusion of clinical photographs in the case report.




Publication History

Article published online:
08 December 2022

© 2022. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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