Satellite Epidemic of Covid-19 Associated Mucormycosis in India: A Multi-Site Observational Study.
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Satija Aanchal, Anand Tanu, Mukherjee Aparna, Velamuri Poonam Sharma, Singh Kh Jitenkumar, Das Madhuchhanda, Josten Kripa, Keche Archana Y, Nagarkar Nitin M, Gupta Prashant, Himanshu D, Mistry Sejal N, Patel Jimy D, Rao Prajwal, Rohatgi Shalesh, Ghosh Soumitra, Hazra Avijit, Kindo Anupma Jyoti, Annamalai Radha, Rudramurthy Shivaprakash M, Singh Mini P, Shameem Mohammad, Fatima Nazish, Khambholja Janakkumar R, Parikh Sangita, Madkaikar Manisha, Pradhan Vandana D, Bhargava Anudita, Mehata Rupa, Arora Ripu Daman, Tigga Richa, Banerjee Gopa, Sonkar Vijay, Malhotra Hardeep Singh, Kumar Neeraj, Patil Rajashri, Raut Chandrashekhar G, Bhattacharyya Kumkum, Arthur Preetam, Somu L, Srikanth Padma, Shah Pankaj B, Panda Naresh K, Sharma Dipti, Hasan Wasil, Ahmed Aftab, Bathla Meeta, Solanki Sunita, Doshi Hiren, Kanani Yash, Patel Nishi, Shah Zincal, Tembhurne Alok Kumar, Rajguru Chhaya, Sankhe Lalitkumar R, Chavan Shrinivas S, Yadav Reetika Malik, Panda Samiran
Аннотация
METHODS: Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2.
RESULTS: A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status.
CONCLUSION: A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases.