Pavan Nanchary, MD, FNB, MBA
Physician
CARE Hospital- Banjara Hills, United States
Disclosure information not submitted.
Subhakar Anna Reddy, MD, IDCCM
Physician
CARE Hospital- Banjara Hills, United States
Disclosure information not submitted.
Ali Rabaan, MD
Physician
Johns Hopkins Aramco Healthcare, United States
Disclosure information not submitted.
Keerti Deepika, MD
Physician
Thomas Jefferson University, United States
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Raghavendra Tirupathi, MD, FACP
Physician
Penn state college of medicine, United States
Disclosure information not submitted.
Thoyaja Koritala, MD
Physician
Mayo Clinic Health System in Mankato, United States
Disclosure information not submitted.
Nitesh Jain, MBBS
Assistant Professor of Medicine
Mayo Clinic College of Medicine, United States
Disclosure information not submitted.
Sanjana Allam, MBBS
Medical Student
Gandhi Medical College, Secunderabad, India, United States
Disclosure information not submitted.
Romil Singh, MD
Resident
n/a
Rochester, Minnesota, United States
Disclosure information not submitted.
Syed Anjum Khan, MD
Assistant Professor of Medicine
Mayo Clinic College of Medicine, United States
Disclosure information not submitted.
Rahul Kashyap, MD, MBA,
Medical Director Research
Wellspan Health-York Hospital
York, Pennsylvania
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Title: Mucormycosis Among COVID-19 Hospitalized Patients During Pandemic Wave 2 in India: A Case Series
Objective: Mucormycosis is not a new diagnosis but it has high incidence among COVID-19 patients in India during second wave of pandemic. Its risk factors and compilations are still be studied. We describe demographics, chronic co-morbidities, treatments, complications, and Intensive care unit admissions, of COVID-19 patients with Mucormycosis.
Methods: We investigated a series of 39 patients with Mucormycosis and pre-infection of COVID 19 between 05/2021 to 07/2021. They were admitted at a tertiary hospital in southern parts of India during the second wave of the COVID 19 pandemic. JMP 16.0 was utilized for descriptive analysis.
Results: Out of total 39 patients, 32 (82%) were males. The median (IQR), age was 49 (42-59) years and BMI was 24 (22.7-27). A vast majority (87%, N=34) of the patients had history of diabetes. None of the patients had history of chronic kidney disease or kidney transplant, or hematological malignancies. Total 36 (92%) of patients received steroid treatment as part of their COVID-19 management. Sino-nasal mucormycosis was predominant and affected 24 (61%) patients, 7 (18%) patients had rhino-cerebral Mucormycosis, and 5 (13%) patient had additional peripheral nervous system involvement. Orbital mucormycosis occurred in combination with rhino-cerebral and sino-nasal in total 6 patients. Total 90% (N=35) were treated with Amphotericin-B and around 43% (N=17) were additionally treated with Posconazole. Total 9 (23%) patients also received Isavuconazole Majority of (87%, n=34) patients had surgical treatment. Total 11 (28%) patients were admitted to the Intensive care unit. Nine (23%) patients had Acute kidney Injury, one (2.5%) each had a pulmonary embolism and shock. All patients were discharged alive.
Discussion and Conclusions: Mucormycosis often referred to as black fungus is a rare but potentially fatal infection if inadequately treated. It’s caused by a group of molds called mucormycetes. The second wave of COVID-19 has affected India substantially during May 2021 and the highest reported cases were < 0.4 million on May 7, 2021. Uncontrolled diabetes, corticosteroids overuse for COVID-19 management may have attributed to the rise of Mucormycosis cases.