Glycemic Control Variations In Covid-19 Associated Mucormycosis”

Abstract

Background: Mucormycosis is opportunistic invasive fungal infection characterised by angioivasion, thrombosis and necrosis of the tissues. Diabetes mellitus being the commonest immunocompromised state predisposing to mucormycosis in India, a study about glycemic control in CAM (covid-19 associated mucormycosis) patients and the severity of mucormycosis was necessary so as to reduce the morbidity and mortality in CAM patients. Methods: A retrospective descriptive study was conducted between May 2021 and July 2021 at Bowring & Lady Curzon hospital. 315 patients with post-covid ROCM (rhino-orbito-cerebral mucormycosis) were included in the study. Glycemic control of the patients was monitored with FBS, PPBS, HBA1C values.The extent and severity of CAM was studied in patients with good and poor glycemic control.. Results: 243 (77.14%) patients were male and 72 (22.86%) were female. 296 (93.97% )patients had prior history of diabetes mellitus and 19 (6.03%) patients had newly detected diabetes mellitus. 275(87.30%) patients had poor glycemic control. 17 (6.18%) patients out of 275 presented with diabetic ketoacidosis (DKA). 40 (12.70%) patients had good glycemic control. Conclusions: Diabetes mellitus has emerged as important risk factor associated with development of mucormycosis. In covid-19, poorly controlled diabetes, steroid induced hyperglycemia, covid induced insulin resistance act as fertile land for the development of mucormycosis. Hence monitoring glycemic status, judicious use of steroids, control of sugars may help in reducing the severity or occurance of mucormycosis. Keywords: Mucormycosis, Diabetes mellitus, Covid-19 associated mucormycosis, Hyperglycemia.