Infection of mucormycosis inpatients in Covid-19: an experience at the tertiary medical center in Maharashtra, India

Abstract

Introduction: Mucormycosis is a rare infection known to be one of the most rapidly progressing and lethal forms of fungal infection in humans, with a high mortality rate of 70–100%. Covid-19 cases were reported from all states of the country, but cases of mucormycosis in the setting of COVID-19 pneumonia were very low and that too reasoned that this was most likely due to the patient’s immune-compromised condition. Aims and Objectives: The aim of this article is to assess mucormycosis in Covid-19 patients and its association with the immune status of patients. Materials and Methods: Over 5 months, from February 2021 to June 2021, a retrospective observational study was conducted at MGM Medical College, Aurangabad, Maharashtra, India. The study included all patients who came for imaging to the Radiology Department with mucormycosis who were either coronavirus-positive or had recovered from coronavirus infection. All patients with a molecular diagnosis of SARS-CoV-2 infection admitted to our hospital and having a clinical diagnosis of invasive fungal infections were included. Results: All 30 (100%) patients were diabetic; 17 of these had uncontrolled blood sugar levels with HbA1C levels >6.5%, and the remaining 13 patients had controlled diabetes. The majority of uncontrolled diabetics (17 out of 30) had invasive mucormycosis, rhino-orbital mucormycosis and rhino-orbital cerebral stage, whereas only 3 subjects with control diabetes had invasive mucormycosis. Five uncontrolled diabetic patients had rhino-orbital cerebral stage, whereas only two controlled had rhino-orbital cerebral stage. There is a significant difference between controlled and uncontrolled diabetes with P-value of 0. Conclusion: Covid-19 connection to invasive mucormycosis infection is extremely dangerous and should be taken seriously. Uncontrolled diabetes and inappropriate use of steroids during the management of Covid-19 are two of the most common causes of disease aggravation, and both must be addressed.

Keywords

• covid-19
• diabetes
• fungal infection
• mucormycosis
• steroid