Mucormycosis and coronavirus disease 2019: Risk factors, clinical presentation and outcome in a tertiary care centre in North India – What have we learned

Abstract

Abstract Aim: The aim of this study is to determine clinical presentation, risk factors and outcome in patients with mucormycosis and coronavirus disease 2019 (COVID-19). Introduction: A wide range of opportunistic infections have been described in patients with COVID-19. Rhino-orbital-cerebral mucormycosis has been increasingly described in patients with COVID-19 disease, but the risk factors and outcomes of such patients are not well described. Materials and Methods: This observational study was conducted in Jawaharlal Nehru Medical College, Aligarh, from 1st May 2021 to 31st August 2021 in 50 patients diagnosed with mucormycosis. Clinical features and risk factors were determined and were correlated with the outcome. Results: Out of the 50 patients under study, male patients outnumbered female patients and 64% of patients were above 40 years of age. The mean delay before admission was 18 ± 16.9 days. Eighty-six percent of patients were discharged satisfactorily and 14% of patients expired. Eighty-two percent of patients had COVID-19 disease. Diabetes mellitus was present in 84% of the patients and 66% of patients had HbA1C levels above 7. Paranasal sinus involvement was the most common presenting feature (62%). On analysing the factors associated with mortality, serum creatinine (P = 0.001), total leucocyte count (TLC) (P < 0.001) and intracranial involvement of mucormycosis (P = 0.02) showed a statistically significant association. However, only TLC showed a significant association when multivariate logistic regression was performed to identify independent significant risk factors for mortality (P = 0.023 odds ratio 1.28 confidence interval 1.035–1.593). Conclusion: Mucormycosis adds to the increasing morbidity and mortality associated with COVID-19 and with early diagnosis and prompt treatment associated with better prognosis.