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CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2023; 59(01): 027-035
DOI: 10.1055/s-0042-1759890
Original Article

A Study on the Impact of Diabetes Mellitus on the Severity of COVID-19-Associated Mucormycosis

Siddharth Madan
1   Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
,
Shelly Dutta
2   Department of Medicine, University College of Medical Sciences and Associated GTB Hospital, 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
,
Ishita Bajaj
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
,
Rahul Sharma
3   Department of Community Medicine, 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
4   Department of ENT, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, Delhi, India
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Abstract

Objectives: Diabetes mellitus (DM) seems the most common predisposing factor for rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to study the impact of DM on the severity of COVID-19-associated ROCM (CAM).

Methods: This was a retrospective analytical study performed over a period of 3 months to assess the impact of DM on the severity of CAM in 100 patients and association of clinical correlates of DM with severity of CAM.

Statistical analysis: The data collected using the study tools were converted into a computer-based spreadsheet and analyzed. The statistical analysis comprised a descriptive analysis that involved calculating means, standard deviations, and proportions. For calculating the significance of the difference of mean between two groups, Student's t-test was applied. In addition, chi-square test (or Fisher's t-test if applicable) was applied to study the significance of association of clinical correlates of DM with severity of CAM for categorical variables and t-test for continuous variables.

Results: The prevalence of DM was 67%. The average presenting blood sugar level was 245.9 ± 99.86 mg%. Glycated hemoglobin level between 4.5 and 6.5% was observed in 57 patients and over 6.5% in 43 subjects. A high body mass index (BMI) of 25 and above was noted in 52 patients. A significantly higher level of presenting blood sugar and a longer duration of hospital stay was noted in patients having stage 3b or higher (p < 0.05) when compared with those having stage 3a or below. No significant correlation was observed in patients in stage 3a or below and those presenting with stage 3b or higher in terms of BMI, waist to hip ratio, or total cholesterol levels. There was a strong correlation between blood sugar level at presentation, severity of DM with the severity of ROCM, and a strong inverse correlation noted between HDL level and severity of ROCM.

Conclusion: A poor metabolic control is associated with a higher risk of a severe disease with intracranial involvement.

Keywords

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


Publication History

Article published online:
22 February 2023

© 2023. 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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