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COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi

BACKGROUND: It is an incontrovertible fact that the Rhino Orbital Cerebral Mucormycosis (ROCM) upsurge is being seen in the context of COVID-19 in India. Briefly presented is evidence that in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 and injudicious use of...

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Autores principales: Meher, Ravi, Wadhwa, Vikram, Kumar, Vikas, Shisha Phanbuh, Daphylla, Sharma, Raman, Singh, Ishwar, Rathore, P.K., Goel, Ruchi, Arora, Ritu, Garg, Sandeep, Kumar, Suresh, Kumar, Jyoti, Agarwal, Munisha, Singh, Meeta, Khurana, Nita, Sagar, Tanu, Manchanda, Vikas, Saxena, Sonal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432976/
https://www.ncbi.nlm.nih.gov/pubmed/34547717
http://dx.doi.org/10.1016/j.amjoto.2021.103220
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author Meher, Ravi
Wadhwa, Vikram
Kumar, Vikas
Shisha Phanbuh, Daphylla
Sharma, Raman
Singh, Ishwar
Rathore, P.K.
Goel, Ruchi
Arora, Ritu
Garg, Sandeep
Kumar, Suresh
Kumar, Jyoti
Agarwal, Munisha
Singh, Meeta
Khurana, Nita
Sagar, Tanu
Manchanda, Vikas
Saxena, Sonal
author_facet Meher, Ravi
Wadhwa, Vikram
Kumar, Vikas
Shisha Phanbuh, Daphylla
Sharma, Raman
Singh, Ishwar
Rathore, P.K.
Goel, Ruchi
Arora, Ritu
Garg, Sandeep
Kumar, Suresh
Kumar, Jyoti
Agarwal, Munisha
Singh, Meeta
Khurana, Nita
Sagar, Tanu
Manchanda, Vikas
Saxena, Sonal
author_sort Meher, Ravi
collection PubMed
description BACKGROUND: It is an incontrovertible fact that the Rhino Orbital Cerebral Mucormycosis (ROCM) upsurge is being seen in the context of COVID-19 in India. Briefly presented is evidence that in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 and injudicious use of corticosteroids may be largely responsible for this malady. OBJECTIVE: To find the possible impact of COVID 19 infection and various co-morbidities on occurrence of ROCM and demonstrate the outcome based on medical and surgical interventions. Methodology. Prospective longitudinal study included patients diagnosed with acute invasive fungal rhinosinusitis after a recent COVID-19 infection. Diagnostic nasal endoscopy (DNE) was performed on each patient and swabs were taken and sent for fungal KOH staining and microscopy. Medical management included Injection Liposomal Amphotericin B, Posaconazole and Voriconazole. Surgical treatment was restricted to patients with RT PCR negative results for COVID-19. Endoscopic, open, and combined approaches were utilized to eradicate infection. Follow-up for survived patients was maintained regularly for the first postoperative month. RESULTS: Out of total 131 patients, 111 patients had prior history of SARS COVID 19 infection, confirmed with a positive RT-PCR report and the rest 20 patients had no such history. Steroids were received as a part of treatment in 67 patients infected with COVID 19. Among 131 patients, 124 recovered, 1 worsened and 6 died. Out of 101 known diabetics, 98 recovered and 3 had fatal outcomes. 7 patients with previous history of COVID infection did not have any evidence of Diabetes mellitus, steroid intake or any other comorbidity. CONCLUSION: It can be concluded that ROCM upsurge seen in the context of COVID-19 in India was mainly seen in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 infection and injudicious use of corticosteroids.
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spelling pubmed-84329762021-09-13 COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi Meher, Ravi Wadhwa, Vikram Kumar, Vikas Shisha Phanbuh, Daphylla Sharma, Raman Singh, Ishwar Rathore, P.K. Goel, Ruchi Arora, Ritu Garg, Sandeep Kumar, Suresh Kumar, Jyoti Agarwal, Munisha Singh, Meeta Khurana, Nita Sagar, Tanu Manchanda, Vikas Saxena, Sonal Am J Otolaryngol Article BACKGROUND: It is an incontrovertible fact that the Rhino Orbital Cerebral Mucormycosis (ROCM) upsurge is being seen in the context of COVID-19 in India. Briefly presented is evidence that in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 and injudicious use of corticosteroids may be largely responsible for this malady. OBJECTIVE: To find the possible impact of COVID 19 infection and various co-morbidities on occurrence of ROCM and demonstrate the outcome based on medical and surgical interventions. Methodology. Prospective longitudinal study included patients diagnosed with acute invasive fungal rhinosinusitis after a recent COVID-19 infection. Diagnostic nasal endoscopy (DNE) was performed on each patient and swabs were taken and sent for fungal KOH staining and microscopy. Medical management included Injection Liposomal Amphotericin B, Posaconazole and Voriconazole. Surgical treatment was restricted to patients with RT PCR negative results for COVID-19. Endoscopic, open, and combined approaches were utilized to eradicate infection. Follow-up for survived patients was maintained regularly for the first postoperative month. RESULTS: Out of total 131 patients, 111 patients had prior history of SARS COVID 19 infection, confirmed with a positive RT-PCR report and the rest 20 patients had no such history. Steroids were received as a part of treatment in 67 patients infected with COVID 19. Among 131 patients, 124 recovered, 1 worsened and 6 died. Out of 101 known diabetics, 98 recovered and 3 had fatal outcomes. 7 patients with previous history of COVID infection did not have any evidence of Diabetes mellitus, steroid intake or any other comorbidity. CONCLUSION: It can be concluded that ROCM upsurge seen in the context of COVID-19 in India was mainly seen in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 infection and injudicious use of corticosteroids. Elsevier Inc. 2022 2021-09-11 /pmc/articles/PMC8432976/ /pubmed/34547717 http://dx.doi.org/10.1016/j.amjoto.2021.103220 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Meher, Ravi
Wadhwa, Vikram
Kumar, Vikas
Shisha Phanbuh, Daphylla
Sharma, Raman
Singh, Ishwar
Rathore, P.K.
Goel, Ruchi
Arora, Ritu
Garg, Sandeep
Kumar, Suresh
Kumar, Jyoti
Agarwal, Munisha
Singh, Meeta
Khurana, Nita
Sagar, Tanu
Manchanda, Vikas
Saxena, Sonal
COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi
title COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi
title_full COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi
title_fullStr COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi
title_full_unstemmed COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi
title_short COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi
title_sort covid associated mucormycosis: a preliminary study from a dedicated covid hospital in delhi
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432976/
https://www.ncbi.nlm.nih.gov/pubmed/34547717
http://dx.doi.org/10.1016/j.amjoto.2021.103220
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