Abstract：
BACKGROUND: During the coronavirus disease (COVID-19) pandemic, an increased incidence of mucormycosis infection was noted globally, the majority being from India. We aimed to study the clinical profile of the mucormycosis patients during the COVID-19 pandemic admitted at tertiary care centers.
METHODS: This is a retrospective record-based observation study conducted at Gandhi Medical College, Bhopal. All suspected or laboratory-proven mucormycosis patients were included. Detailed data on demography, clinical features, risk factors, laboratory/radiological findings, and outcomes were recorded.
RESULTS: A total of 288 patients were enrolled and 121(42%) showed mucormycosis on potassium hydroxide (KOH) mount. The mean age was 51.52 ± 10.88 years, male:female ratio was 2.3:1. Most common symptom was facial swelling/pain and fever. The most common risk factor was COVID-19 infection (78.5%) followed by the presence of diabetes mellitus (DM) (70.8%) out of which 152 (52.8%) patients were previously diagnosed cases and 52 (18%) patients were newly diagnosed, 159 (55.2%) had a history of corticosteroid use, 87 (30.2%) had a history of use of oxygen support and 67 (23.2%) had hypertension. Most patients had invasion limited to sinus (46.5%) but the presence of DM was associated with an increased risk of cerebral invasion. Out of 288 patients admitted with mucormycosis, 31 patients collapsed to death while the remaining 257 patients were discharged from the hospital.
CONCLUSIONS: It is observed that during the COVID-19 pandemic, hyperglycemia and inappropriate use of corticosteroids were associated with an increased risk of development of mucormycosis in patients with or without DM. We conclude that regular blood glucose monitoring, adequate glycemic control, and judicious evidence-based use of corticosteroids and immunosuppressants in COVID-19 are recommended to reduce the emergence of mucormycosis in such circumstances.
METHODS: This is a retrospective record-based observation study conducted at Gandhi Medical College, Bhopal. All suspected or laboratory-proven mucormycosis patients were included. Detailed data on demography, clinical features, risk factors, laboratory/radiological findings, and outcomes were recorded.
RESULTS: A total of 288 patients were enrolled and 121(42%) showed mucormycosis on potassium hydroxide (KOH) mount. The mean age was 51.52 ± 10.88 years, male:female ratio was 2.3:1. Most common symptom was facial swelling/pain and fever. The most common risk factor was COVID-19 infection (78.5%) followed by the presence of diabetes mellitus (DM) (70.8%) out of which 152 (52.8%) patients were previously diagnosed cases and 52 (18%) patients were newly diagnosed, 159 (55.2%) had a history of corticosteroid use, 87 (30.2%) had a history of use of oxygen support and 67 (23.2%) had hypertension. Most patients had invasion limited to sinus (46.5%) but the presence of DM was associated with an increased risk of cerebral invasion. Out of 288 patients admitted with mucormycosis, 31 patients collapsed to death while the remaining 257 patients were discharged from the hospital.
CONCLUSIONS: It is observed that during the COVID-19 pandemic, hyperglycemia and inappropriate use of corticosteroids were associated with an increased risk of development of mucormycosis in patients with or without DM. We conclude that regular blood glucose monitoring, adequate glycemic control, and judicious evidence-based use of corticosteroids and immunosuppressants in COVID-19 are recommended to reduce the emergence of mucormycosis in such circumstances.
摘要：
背景：在冠状病毒病（COVID-19）大流行期间，全球注意到毛霉菌病感染的发病率增加，大部分来自印度。我们的目的是研究三级护理中心收治的COVID-19大流行期间毛霉菌病患者的临床特征。
方法：这是一项在甘地医学院进行的基于记录的回顾性观察研究，博帕尔.包括所有疑似或实验室证实的毛霉菌病患者。关于人口统计的详细数据，临床特征,危险因素，实验室/放射学发现，并记录结果。
结果：共纳入288例患者，其中121例（42%）在氢氧化钾（KOH）上显示毛霉菌病。平均年龄51.52±10.88岁,男性：女性比例为2.3：1。最常见的症状是面部肿胀/疼痛和发热。最常见的危险因素是COVID-19感染(78.5%)，其次是糖尿病(DM)(70.8%)，其中152例(52.8%)患者是先前诊断的病例，52例(18%)患者是新诊断的。159（55.2％）有皮质类固醇使用史，87（30.2％）有使用氧气支持的病史，67（23.2％）有高血压。大多数患者的侵袭仅限于鼻窦（46.5％），但DM的存在与脑侵袭的风险增加有关。在288例毛霉菌病患者中，31名患者倒塌死亡，其余257名患者出院。
结论：观察到在COVID-19大流行期间，在有或没有DM的患者中,高血糖和不适当使用皮质类固醇与发展毛霉菌病的风险增加相关.我们得出结论，定期血糖监测，适当的血糖控制，在这种情况下，建议在COVID-19中明智地使用皮质类固醇和免疫抑制剂，以减少毛霉菌病的出现。
方法：这是一项在甘地医学院进行的基于记录的回顾性观察研究，博帕尔.包括所有疑似或实验室证实的毛霉菌病患者。关于人口统计的详细数据，临床特征,危险因素，实验室/放射学发现，并记录结果。
结果：共纳入288例患者，其中121例（42%）在氢氧化钾（KOH）上显示毛霉菌病。平均年龄51.52±10.88岁,男性：女性比例为2.3：1。最常见的症状是面部肿胀/疼痛和发热。最常见的危险因素是COVID-19感染(78.5%)，其次是糖尿病(DM)(70.8%)，其中152例(52.8%)患者是先前诊断的病例，52例(18%)患者是新诊断的。159（55.2％）有皮质类固醇使用史，87（30.2％）有使用氧气支持的病史，67（23.2％）有高血压。大多数患者的侵袭仅限于鼻窦（46.5％），但DM的存在与脑侵袭的风险增加有关。在288例毛霉菌病患者中，31名患者倒塌死亡，其余257名患者出院。
结论：观察到在COVID-19大流行期间，在有或没有DM的患者中,高血糖和不适当使用皮质类固醇与发展毛霉菌病的风险增加相关.我们得出结论，定期血糖监测，适当的血糖控制，在这种情况下，建议在COVID-19中明智地使用皮质类固醇和免疫抑制剂，以减少毛霉菌病的出现。
