Clinical Profile of Patients Admitted With Mucormycosis During the COVID-19 Pandemic in Medicine Emergency of a Tertiary Care Hospital in North India

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has taken the world as a storm, has been indisputably found to be associated with mild to life-threatening pneumonia in the majority of patients. Mucormycosis emerged as a life-threatening complication of coronavirus disease 2019 (COVID-19) in India during the second wave of the COVID-19 pandemic. There lies a large lacuna in the understanding of the disease progression and the association of mucormycosis with COVID-19 and the various predisposing factors. Aim: To assess the pattern, risk factors, and outcome of mucormycosis cases reported to hospitals in North India during the second wave of the COVID-19 pandemic. Material and methods: An observational, prospective study was conducted for 109 patients reporting to a medical emergency with a history of suspected or confirmed mucormycosis from May 2021 to July 2021. Obtained data were analysed using descriptive statistics and results were expressed as a percentage and mean. Results: Out of 109 patients, 75 were male and 34 were female with a mean age of 50.6 years, most cases belong to the rural background. The most common types of mucormycosis were rhino-orbital (34.8%), rhino-orbital cerebral (20.18%), and pulmonary (23.8%). The most common risk factors were uncontrolled diabetes (80 %), use of steroids (68.8%), diabetic ketoacidosis (42%), and COVID-19 positive status (66.9%). High mortality of 33.9% was seen in our study. Conclusions: The most vulnerable group in our study were patients with pulmonary manifestations (51.4%) and patients requiring oxygen therapy (94.6%). Our study found that scoring systems namely the quick sequential organ failure assessment (q SOFA) scoring system (p-value <0.001) along with the Glasgow Coma Scale (p-value <0.038) can be used as a prognostic indicator and good assessment tools for the degree of severity of disease at an early stage.