Clinical presentations, epidemiology and management of COVID-19 associated Mucor mycosis in a tertiary care hospital in South India

Abstract

To study the statistics of the epidemiology, co-morbidities, clinical presentations, management and prognosis of the study group. This is a retrospective study conducted in a tertiary care hospital in South India, among 100 subjects, between May 2021 and August 2021 when the Mucor mycosis cases were frequently being diagnosed and treated amongst COVID-19 infected patients. The results showed that 34.0% were between 51-60 years with 100% patients confirmed COVID positive through RTPCR tests. 86.0% had confirmed mucor on CT scan. 50.0% had both eyes vision of 6/60 on presentation. 67.% had periorbital swelling with 51% having prior co-morbidities.63.0% patients received tablet Posaconazole 30mg as medical treatment and 60.0% required no surgical management.10.0% required orbital exenteration and 21.0% required partial maxillectomy.2% experienced orbital apex syndrome as associated complications.97.0% were discharged post treatment with 3% mortality. There was a positive correlation of medical management with respect to anterior segment and posterior segment findings P<0.001 and P=0.79. There was a positive correlation between surgical treatment and anterior and posterior segment findings P<0.001 and P=0.43. There was a positive correlation between co-morbidities and death P<0.001, with 32.0% uncontrolled diabetics. This study shows that immune suppression is directly related to infectivity by mucor mycosis. In order to contain symptomatology and grave prognosis amongst patients, early diagnosis, affordable treatment and follow-up including patient education about the etiology and pathogenesis of the disease must be available.