Abstract：
BACKGROUND: Mucormycosis mostly targets immunocompromised patients or those with uncontrolled diabetes but is now an important complication after coronavirus disease 2019 (COVID-19) infection. The stage of mucormycosis at presentation greatly impacts its treatment course and prognosis. Prior research has failed to evaluate an association of patient factors, especially glycated hemoglobin (HbA1c) levels and random blood sugar (RBS) at presentation, with the stage and outcome of mucormycosis.
OBJECTIVE: To investigate the relationship between glycemic control and the stage of mucormycosis at presentation and to investigate various factors affecting mucormycosis outcome.
METHODS: All patients with clinicopathologically confirmed mucormycosis presenting to Safdarjung Hospital, New Delhi, during the COVID-19 pandemic were enrolled in the study. A questionnaire consisting of demographic information, comorbidities, history, and treatment of COVID-19 and diabetes was filled out at the time of admission. Blood glucose and HbA1c levels at presentation were noted. The above-noted parameters were compared with the stage and outcome of mucormycosis. The data obtained was analyzed.
RESULTS: A total of 75 mucormycosis patients were enrolled in the study. The mean age of the participants was 45.17 years, and 85.33% of them survived the disease course. There was no statistically significant difference between the survivors and nonsurvivors concerning mean HbA1c and RBS levels. But there was a statistically significant correlation such that the stage of mucormycosis increased with progressive worsening glycemic control markers HbA1c and RBS. The most common comorbid condition was diabetes mellitus (72%); however, only coronary artery disease in the patient was significantly correlated with mortality. A history of COVID-19 infection was reported in 67.6% of the patients, but this was not significantly associated with mortality outcomes. Patients without a history of COVID-19 reported significantly higher RBS and HbA1c levels at presentation than the COVID-19-associated mucormycosis group.
CONCLUSIONS: The study showed a positive correlation between the stage of mucormycosis and serum glycemic control markers at presentation. Clinicians must order blood sugar and HbA1c levels at presentation as cues for a better understanding of disease severity. A thorough clinical examination and history taking for patient risk factors predisposing to mucormycosis are also crucial since the presence of proptosis and coronary artery disease are significantly correlated with the mortality outcomes. The extent of poor glycemic control at presentation was not associated with mortality outcomes. How to cite this article: Sharma V, Kriplani K, Tuli IP, et al. Glycemic Control and Mucormycosis during COVID-19 Pandemic in India a Study of Stage and Outcome. J Assoc Physicians India 2023;71(9):61-66.
OBJECTIVE: To investigate the relationship between glycemic control and the stage of mucormycosis at presentation and to investigate various factors affecting mucormycosis outcome.
METHODS: All patients with clinicopathologically confirmed mucormycosis presenting to Safdarjung Hospital, New Delhi, during the COVID-19 pandemic were enrolled in the study. A questionnaire consisting of demographic information, comorbidities, history, and treatment of COVID-19 and diabetes was filled out at the time of admission. Blood glucose and HbA1c levels at presentation were noted. The above-noted parameters were compared with the stage and outcome of mucormycosis. The data obtained was analyzed.
RESULTS: A total of 75 mucormycosis patients were enrolled in the study. The mean age of the participants was 45.17 years, and 85.33% of them survived the disease course. There was no statistically significant difference between the survivors and nonsurvivors concerning mean HbA1c and RBS levels. But there was a statistically significant correlation such that the stage of mucormycosis increased with progressive worsening glycemic control markers HbA1c and RBS. The most common comorbid condition was diabetes mellitus (72%); however, only coronary artery disease in the patient was significantly correlated with mortality. A history of COVID-19 infection was reported in 67.6% of the patients, but this was not significantly associated with mortality outcomes. Patients without a history of COVID-19 reported significantly higher RBS and HbA1c levels at presentation than the COVID-19-associated mucormycosis group.
CONCLUSIONS: The study showed a positive correlation between the stage of mucormycosis and serum glycemic control markers at presentation. Clinicians must order blood sugar and HbA1c levels at presentation as cues for a better understanding of disease severity. A thorough clinical examination and history taking for patient risk factors predisposing to mucormycosis are also crucial since the presence of proptosis and coronary artery disease are significantly correlated with the mortality outcomes. The extent of poor glycemic control at presentation was not associated with mortality outcomes. How to cite this article: Sharma V, Kriplani K, Tuli IP, et al. Glycemic Control and Mucormycosis during COVID-19 Pandemic in India a Study of Stage and Outcome. J Assoc Physicians India 2023;71(9):61-66.
摘要：
背景：毛霉菌病主要针对免疫功能低下的患者或患有不受控制的糖尿病的患者，但现在是2019年冠状病毒病（COVID-19）感染后的重要并发症。毛霉菌病的出现阶段极大地影响了其治疗过程和预后。先前的研究未能评估患者因素的关联，尤其是糖化血红蛋白（HbA1c）水平和随机血糖（RBS），毛霉菌病的阶段和结果。
目的：探讨血糖控制与毛霉菌病分期的关系，并探讨影响毛霉菌病转归的各种因素。
方法：所有到Safdarjung医院就诊的经临床病理证实的毛霉菌病患者，新德里,在COVID-19大流行期间,我们纳入了这项研究.由人口统计信息组成的问卷，合并症,历史,入院时填写了COVID-19和糖尿病的治疗。注意到出现时的血糖和HbA1c水平。将上述参数与毛霉菌病的阶段和结果进行了比较。分析获得的数据。
结果：本研究共纳入75例毛霉菌病患者。参与者的平均年龄是45.17岁,其中85.33%的人在病程中存活。在平均HbA1c和RBS水平方面，幸存者和非幸存者之间没有统计学上的显着差异。但是存在统计学上的显着相关性，使得毛霉菌病的阶段随着血糖控制标志物HbA1c和RBS的进行性恶化而增加。最常见的合并症是糖尿病（72％）；然而，患者中只有冠状动脉疾病与死亡率显著相关.67.6%的患者报告有COVID-19感染史，但这与死亡率结局无显著相关.没有COVID-19病史的患者报告的RBS和HbA1c水平明显高于COVID-19相关毛霉菌病组。
结论：研究表明，毛霉菌病的分期与出现时的血清血糖控制指标之间呈正相关。临床医生必须在出现时将血糖和HbA1c水平作为提示，以更好地了解疾病的严重程度。由于眼球突出和冠状动脉疾病的存在与死亡率结果显着相关，因此对患者易感毛霉菌病的危险因素进行全面的临床检查和病史检查也至关重要。出现时血糖控制不良的程度与死亡率结果无关。如何引用这篇文章:SharmaV,KriplaniK,TuliIP,etal.印度COVID-19大流行期间的血糖控制和毛霉菌病的阶段和结果研究。J印度Assoc医师2023；71（9）：61-66。
目的：探讨血糖控制与毛霉菌病分期的关系，并探讨影响毛霉菌病转归的各种因素。
方法：所有到Safdarjung医院就诊的经临床病理证实的毛霉菌病患者，新德里,在COVID-19大流行期间,我们纳入了这项研究.由人口统计信息组成的问卷，合并症,历史,入院时填写了COVID-19和糖尿病的治疗。注意到出现时的血糖和HbA1c水平。将上述参数与毛霉菌病的阶段和结果进行了比较。分析获得的数据。
结果：本研究共纳入75例毛霉菌病患者。参与者的平均年龄是45.17岁,其中85.33%的人在病程中存活。在平均HbA1c和RBS水平方面，幸存者和非幸存者之间没有统计学上的显着差异。但是存在统计学上的显着相关性，使得毛霉菌病的阶段随着血糖控制标志物HbA1c和RBS的进行性恶化而增加。最常见的合并症是糖尿病（72％）；然而，患者中只有冠状动脉疾病与死亡率显著相关.67.6%的患者报告有COVID-19感染史，但这与死亡率结局无显著相关.没有COVID-19病史的患者报告的RBS和HbA1c水平明显高于COVID-19相关毛霉菌病组。
结论：研究表明，毛霉菌病的分期与出现时的血清血糖控制指标之间呈正相关。临床医生必须在出现时将血糖和HbA1c水平作为提示，以更好地了解疾病的严重程度。由于眼球突出和冠状动脉疾病的存在与死亡率结果显着相关，因此对患者易感毛霉菌病的危险因素进行全面的临床检查和病史检查也至关重要。出现时血糖控制不良的程度与死亡率结果无关。如何引用这篇文章:SharmaV,KriplaniK,TuliIP,etal.印度COVID-19大流行期间的血糖控制和毛霉菌病的阶段和结果研究。J印度Assoc医师2023；71（9）：61-66。
