AI Article Synopsis
- This study investigates post-COVID rhino-cerebralorbital mucormycosis (RCOM), focusing on its epidemiology, risk factors, and treatment outcomes in a hospital setting.
- Most patients affected are middle-aged males with a high prevalence of diabetes and use of glucocorticoids, with symptoms typically appearing within two weeks post-COVID.
- Effective management includes prompt use of antifungal drugs and surgical intervention, particularly for those with advanced disease stages, significantly improving patient survival rates.
Article Abstract
Objective: This study aims to describe the epidemiology, predisposing factors, clinical manifestations, management, and outcome of post-COVID rhino-cerebralorbital mucormycosis.
Methods: This is a prospective observational study of patients with post-COVID RCOM conducted tertiary care hospital during May-June 2021.
Results: The mean age of patients was 49.58±15.12 years and majority (64.80%) were male. The majority of patients were rural, Hindu and illiterate. Diabetes was present 78.10% patients, glucocorticoids were required in 66.30%, and supplemental oxygen was used in 27.60% of patients. Most of the patients developed symptoms of RCOM within 15 days of COVID-19. Majority of patients (46.67%) had stage 3 disease and orbit was involved in 60% of patients. All patients received intravenous antifungal drugs and combined antifungal drugs and surgical debridement was performed in 77.10% patients. Predictor associated with poor outcome were RCOM stage 3c or above and qSOFA score ≥2 at presentation.
Conclusion: Diabetes and glucocorticoids are the most important risk factors for post-COVID RCOM. COVID-19 patients must be followed closely for 2-4 weeks to detect mucormycosis as earlier as possible. Antifungal drugs should be started immediately if clinico-radiological feature suggest RCOM before microbiological confirmation. Combined medical and surgical treatment significantly reduces mortality.
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