PathologyP-36666236-301Oral and cranio-maxillo-facial mucormycosis 2020 - A consequence of Covid -19?

Abstract

BackgroundA rapid rise in craniomaxillofacial Mucormycosis was seen post Covid 19 in India from August 2020 to July 2021. The aim of this study was to explore the possible causative associations observed in these Mucormycosis casesMaterial & MethodsOver 550 cases, 70 after the first Covid wave and 480 after the second Covid wave reported to our institute. Associations were looked for with demographic variables, H/o hospitalization and steroids admission during Covid infection, pre-existing medical conditions specially diabetes, H/o vaccination, extent of craniofacial involvement, surgical and medicinal therapy given, the mortality rate and recurrence.ResultsOut of 550 patients; 65% were male. The most common age group affected was 40-60 years, 77% patients reported H/O Covid, 64% patients gave H/ohospitalization, 70% patients were diabetic, 64.4% patient had received steroids,8.18% of patients had received a single dose of vaccine and average D dimer level was between 0.8 to 1.4 g/L. Only maxilla was affected in 63%, both the maxilla and zygoma in 19.63%, maxilla & orbital floor in 8%, 6.4% showed intracranial extension and 2.72% presented with mucormycosis of the mandible. Mortality rate was 5.09% and recurrence was noted in 7.6%.ConclusionMucormycosis is generally observed in immunocompromised patients, post cancer or post organ transplant therapy. However, a sudden outbreak of Mucormycosis in post Covid-19 patients, especially those who were hospitalized and received steroid therapy following which transient hyperglycemia occurred, shows a definite correlation between Mucormycosis and Covid-19.