Publication:

COVID-19 associated mucormycosis during the second wave of pandemic in South India

Background The incidence of mucormycosis has risen more rapidly during the second wave compared with the first wave of COVID-19 in India. As with the other parts of the country, our state also experience surge of mucormycosis cases among COVID-19 patients admitted in our hospitals. The surge of COVID-19 associated mucormycosis (CAM) which was new for the whole medical community with no prior experience.  In this context a prospective descriptive study was conducted.

Methods The study was done at a public sector tertiary care hospital in Kerala, South India from April to June 2021 prospectively.

Results During our study period of three months total 40 cases were reported with diagnosis of mucormycosis. Sex wise 29 (72.5%) were males and 11 (27.5%) were females. The mean age was 55.8+16 years. Thirty three (83%) cases were confirmed to be CAM by real time reverse transcriptase polymerase chain reaction (RTPCR) test. Thirty one (79%) of them have got associated risk factor diabetes mellitus. Twenty six (65%) had undergone steroid treatment. Other associated risk factors were hypoxia 10 (25%), zinc supplement 30 (75%), steam inhalation 14 (35%), and intensive care unit (ICU) admission 6 (15%). All the cases were rhino orbito cerebral type. Majority 26 (65%) received medical and surgical treatment. The outcome wise 16 (40%) patients were discharged after cure and case fatality rate was 4 (10%).

Conclusions In our study CAM was highly associated with increasing age above 50, diabetes, steroid use and zinc supplementation. The health care workers and patients should be made aware of the importance of glycemic control, over use of steroids.