Mycology (Jan 2024)

Baseline findings of a multicentric ambispective cohort study (2021–2022) among hospitalised mucormycosis patients in India

  • Rizwan Suliankatchi Abdulkader,
  • Manickam Ponnaiah,
  • Tarun Bhatnagar,
  • Devika S,
  • Amanda G.A Rozario,
  • Gayathri K,
  • Malu Mohan,
  • Michaelraj E,
  • Divya Saravanakumar,
  • Aditya Moorthy,
  • Amit Kumar Tyagi,
  • Bhagirathsinh D Parmar,
  • K Devaraja,
  • Gaurav Medikeri,
  • Jutika Ojah,
  • Kajal Srivastava,
  • Karthikeyan K,
  • Nandini Das,
  • Niharika B,
  • Parul Sharma,
  • Pradipta Kumar Parida,
  • Prasanna Kumar Saravanam,
  • Praveen Kulkarni,
  • Priya S,
  • Pushpa Patil S,
  • Rahul Kumar Bagla,
  • Ramesh D,
  • Renuka S Melkundi,
  • Satish S Satpute,
  • Seetharaman Narayanan,
  • Shubhashri Jahagirdar,
  • Simmi Dube,
  • Sunil Kumar Panigrahi,
  • Surendra Babu D,
  • Vaibhav Saini,
  • Rita Singh Saxena,
  • Abhinav Srivastava,
  • Achyut Chandra Baishya,
  • Ajai Garg,
  • Amit Kumar Mishra,
  • Anjan Jyoti Talukdar,
  • Ankita Kankaria,
  • Arathi Karat,
  • Arul Sundaresh Kumar,
  • Ashi Chug,
  • Ashok Vankundre,
  • Balakrishnan Ramaswamy,
  • Bharathi MB,
  • Bhargav R Jadav,
  • Muthuswamy Dhiwakar,
  • Girija Ghate,
  • Hardik V Shah,
  • Ipsita Saha,
  • Kavya Sivapuram,
  • Krupal J Joshi,
  • Mahendra Singh,
  • Mukesh Chand Bairwa,
  • Divya K,
  • Karthikeyan K,
  • Muthurajesh E,
  • Navneh Samagh,
  • Nethra Dinakaran,
  • Nikhil Gupta,
  • Nitin Gupta,
  • Nitin M Nagarkar,
  • Nitin Solanki,
  • Prasan Kumar Panda,
  • Prithvi Bachalli,
  • Raghunath Shanbag,
  • Rajashri Patil,
  • Rajesh Kumar A,
  • Rakesh Narayan Patil,
  • Ramanikanth Thookkanaickenpalayam Vijayaraghavan,
  • Ramesh Hanumantappa,
  • Rathinavel A,
  • Saleel Kumar Mandal,
  • Sanjay Pandharinath Kishve,
  • Sara Varghese Thomas,
  • Saurav Sarkar,
  • Shalini Thakur,
  • Siddaram Patil,
  • Somu Lakshmanan,
  • Srinivas D Rao,
  • Sumathi V,
  • Tulasi Nayak,
  • Umesh R Dixit,
  • Unnikrishnan B,
  • Varsha Backiavathy,
  • Vijendra Shenoy,
  • Vinay Kumar Hallur,
  • Aparna Bhatnagar,
  • Manoj V Murhekar

DOI
https://doi.org/10.1080/21501203.2023.2271928
Journal volume & issue
Vol. 15, no. 1
pp. 70 – 84

Abstract

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In India, the incidence of mucormycosis reached high levels during 2021–2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March–July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease’s clinical progression and help frame standard treatment guidelines.

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