MUCORMYCOSIS IN COVID 19- 2ND WAVE : CLINICAL PROFILE IN CENTRAL INDIA

Abstract

A sudden surge of Rhino-Orbito-Cerebral Mucormycosis (ROCM) was observed following second wave of Covid-19 in India. Diabetes mellites (DM) , steroids, hypoxia, hyperglycemia ,metabolic acidosis or Diabetic ketoacidosis, high serum iron levels, zinc supplementation, immunosuppression along with other risk factors have been found to facilitate fungal germination. Patients diagnosed with ROCM, a total of 273, were included in the study. Detailed history was noted and assessment was done. Male:Female ratio was 2.59:1. Most common presenting age group was 31 to 50 yrs (51.65%). The commonest presenting symptom was nasal obstruction (58.97%) followed by ipsilateral facial swelling (53.11%). Palatal ulceration, blood stained nasal discharge ,orbital swelling, diminution or loss of vision, headache, loosening of teeth were among other presentations. Common associated comorbidity was diabetes(84.61%), hypertension (HTN) , anemia, immunocompromised state etc. History of associated past covid infection was seen in 75.52% while 18.68% had coexisting mucor with covid. History of steroid use was in 86.81%, O2 administration by mask in 64.10%, ventilatory support in 5.12 % and tablet zinc intake in 86.45%. Covid-19 along with DM, HTN, anemia, steroid therapy and oxygen therapy are the risk factors for ROCM. Thus regular blood sugar monitoring , judicious use of corticosteroids, maintaining hygiene of mask and circuit during oxygen therapy is recommended while treating covid.