DETECTION OF RISK FACTORS AND PATIENT CHARACTERISTICS ASSOCIATED WITH MUCORMYCOSIS TO DESIGN SCREENING TOOLS HELPFUL IN PREVENTING ADVERSITIES AT PRIMARY CARE LEVEL: A CASE CONTROL STUDY

Abstract

Background:Timely screening, early suspicion and accurate diagnostic measures are needed at primary care level to prevent catastrophe by events such as the recent and sudden emergence of COVID-19 associated mucormycosis (CAM). This entity which was observed during the second wave of this pandemic in India had caused severe chaos by its sudden appearance and frequent devastating outcomes. To identify the underlying risk factors, clinical characteri Objectives: stics and presentation in CAM cases enabling an early diagnostic approach by use of screening tools at primary care. A retrospect Methods: ive case-control study (April to June 2021) among those fullling the diagnostic criteria of mucormycosis with a prior COVID-19 infection. 50 patients with mucormycosis as cases and Results: 100 without as controls were enrolled in the study. The median duration from COVID-19 till the onset of CAM was 15 days. The mean age was 50 years and male preponderance, with most commonly reported infection sites nose and sinus (90%) and pansinusitis a predominant nding in CECT (contrast enhanced computed tomography). About 84% (42/50) CAM patients had diabetes mellitus and 60% had received corticosteroid treatment for COVID19. 13/50 (26%) cases had history of hypertensions. History of previous hospitalization was present in 60% (30/50) patients during COVID 19 infection and 26% patients had received oxygen therapy. Serum ferritin levels were available for 19, with elevated level s in 8/19 cases, 11/19 had normal range, 5/50 cases had received Remdesivir injection, only 10/50CAM patients had received a single dose of COVID-19 vaccine, others were non-vaccinated. Current study unveiled thatuncontrolled diabe Summary : tes mellitus and those who inadvertently receive corticosteroid therapy are at increased risk of CAM. With the ongoing pandemic and increasing number of CAM cases, patients positive for these risk factors during COVID management need regular screening at primary care level in order to prevent this deadly and often fatal secondary infection.