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A study on epidemiology, clinical profile, management, and outcome of Covid-19-associated rhino-orbital-cerebral mucormycosis in a tertiary hospital in Tamil Nadu

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Original Article

Author Details : Hannah Ratna Priya*, Sumathi Periasamy, Shanmugapriya Sekar

Volume : 9, Issue : 2, Year : 2023

Article Page : 261-264

https://doi.org/10.18231/j.ijceo.2023.049

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Abstract

Objective: The main objective of the study is to estimate determine the patient demographics, comorbidities, and medications used to treat COVID-19, presenting symptoms and signs, and the outcome of management of COVID-19-associated rhino-orbital-cerebral mucormycosis (ROCM).
Materials and Methods: A descriptive cross-sectional study was conducted among 50 patients admitted and suspected with Mucormycosis in 3 months duration from May 21 to July 21 Covid pandemic at a tertiary hospital in Villupuram. Written informed consentwas taken from patients or nearest of kin. This study was approved by Institutional Ethical Committee of Villupuram.
Results: 84% patients among suspected mucormycosis were found to be diabetic, with 70% being males and 61.9% had covid history either covid positive or post covid status. About 60% of suspected mucor cases had h/o oxygen treatment and almost 44% had h/o steroid treatment for their covid treatment. Clinically 40% had extraocular muscle involvement in the form of restricted eye movement to total ophthalmoplegia and mortality was ranging from 37.5-57.14%. Those with proper glycemic control and initiation of treatment at appropriate time with endoscopic sinus debridement and antifungal therapy showed better recovery.
Conclusion: The study reveals that COVID-19 associated Mucormycosis has risen dramatically due to interplay of uncontrolled diabetes and in-appropriate corticosteroid use leading to pathogenic invasion and adverse outcomes. The infection has caused high morbidity and mortality among covid positive than post covid patients. It could be minimized by strict diabetic control under appropriate insulin dosage, wise use of steroids/oxygen and timely intervention based on clinical evaluation rather than waiting for investigations could minimize the complications from the infection and shorten the hospital stay.
 

Keywords: COVID- 19, Mucormycosis, COVID- 19 associated ROCM, Diabetes mellitus, Steroid therapy, Ophthalmoplegia, Functional endoscopic sinus surgery, Transcutaneous retrobulbar amphotericin B.

How to cite : Priya H R, Periasamy S, Sekar S, A study on epidemiology, clinical profile, management, and outcome of Covid-19-associated rhino-orbital-cerebral mucormycosis in a tertiary hospital in Tamil Nadu. Indian J Clin Exp Ophthalmol 2023;9(2):261-264

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