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A case control investigation of COVID-19 associated mucormycosis in India

BACKGROUND: Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and...

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Autores principales: Anand, Tanu, Mukherjee, Aparna, Satija, Aanchal, Velamuri, Poonam Sharma, Singh, Kh. Jitenkumar, Das, Madhuchhanda, Josten, Kripa, Yadav, Pragya D., Sahay, Rima R., Keche, Archana Y., Nagarkar, Nitin M., Gupta, Prashant, Himanshu, D., Mistry, Sejal N., Patel, Jimy D., Rao, Prajwal, Rohatgi, Shalesh, Ghosh, Soumitra, Hazra, Avijit, Kindo, Anupma Jyoti, Annamalai, Radha, Rudramurthy, Shivaprakash M., Singh, Mini P., Shameem, Mohammad, Fatima, Nazish, Khambholja, Janakkumar R., Parikh, Sangita, Madkaikar, Manisha, Pradhan, Vandana D., Kataria, Sushila, Sharma, Pooja, Panda, Samiran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667849/
https://www.ncbi.nlm.nih.gov/pubmed/36384482
http://dx.doi.org/10.1186/s12879-022-07844-y
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author Anand, Tanu
Mukherjee, Aparna
Satija, Aanchal
Velamuri, Poonam Sharma
Singh, Kh. Jitenkumar
Das, Madhuchhanda
Josten, Kripa
Yadav, Pragya D.
Sahay, Rima R.
Keche, Archana Y.
Nagarkar, Nitin M.
Gupta, Prashant
Himanshu, D.
Mistry, Sejal N.
Patel, Jimy D.
Rao, Prajwal
Rohatgi, Shalesh
Ghosh, Soumitra
Hazra, Avijit
Kindo, Anupma Jyoti
Annamalai, Radha
Rudramurthy, Shivaprakash M.
Singh, Mini P.
Shameem, Mohammad
Fatima, Nazish
Khambholja, Janakkumar R.
Parikh, Sangita
Madkaikar, Manisha
Pradhan, Vandana D.
Kataria, Sushila
Sharma, Pooja
Panda, Samiran
author_facet Anand, Tanu
Mukherjee, Aparna
Satija, Aanchal
Velamuri, Poonam Sharma
Singh, Kh. Jitenkumar
Das, Madhuchhanda
Josten, Kripa
Yadav, Pragya D.
Sahay, Rima R.
Keche, Archana Y.
Nagarkar, Nitin M.
Gupta, Prashant
Himanshu, D.
Mistry, Sejal N.
Patel, Jimy D.
Rao, Prajwal
Rohatgi, Shalesh
Ghosh, Soumitra
Hazra, Avijit
Kindo, Anupma Jyoti
Annamalai, Radha
Rudramurthy, Shivaprakash M.
Singh, Mini P.
Shameem, Mohammad
Fatima, Nazish
Khambholja, Janakkumar R.
Parikh, Sangita
Madkaikar, Manisha
Pradhan, Vandana D.
Kataria, Sushila
Sharma, Pooja
Panda, Samiran
author_sort Anand, Tanu
collection PubMed
description BACKGROUND: Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. METHODS: Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. RESULTS: CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. CONCLUSIONS: Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-022-07844-y.
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spelling pubmed-96678492022-11-16 A case control investigation of COVID-19 associated mucormycosis in India Anand, Tanu Mukherjee, Aparna Satija, Aanchal Velamuri, Poonam Sharma Singh, Kh. Jitenkumar Das, Madhuchhanda Josten, Kripa Yadav, Pragya D. Sahay, Rima R. Keche, Archana Y. Nagarkar, Nitin M. Gupta, Prashant Himanshu, D. Mistry, Sejal N. Patel, Jimy D. Rao, Prajwal Rohatgi, Shalesh Ghosh, Soumitra Hazra, Avijit Kindo, Anupma Jyoti Annamalai, Radha Rudramurthy, Shivaprakash M. Singh, Mini P. Shameem, Mohammad Fatima, Nazish Khambholja, Janakkumar R. Parikh, Sangita Madkaikar, Manisha Pradhan, Vandana D. Kataria, Sushila Sharma, Pooja Panda, Samiran BMC Infect Dis Research BACKGROUND: Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. METHODS: Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. RESULTS: CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. CONCLUSIONS: Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-022-07844-y. BioMed Central 2022-11-16 /pmc/articles/PMC9667849/ /pubmed/36384482 http://dx.doi.org/10.1186/s12879-022-07844-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Anand, Tanu
Mukherjee, Aparna
Satija, Aanchal
Velamuri, Poonam Sharma
Singh, Kh. Jitenkumar
Das, Madhuchhanda
Josten, Kripa
Yadav, Pragya D.
Sahay, Rima R.
Keche, Archana Y.
Nagarkar, Nitin M.
Gupta, Prashant
Himanshu, D.
Mistry, Sejal N.
Patel, Jimy D.
Rao, Prajwal
Rohatgi, Shalesh
Ghosh, Soumitra
Hazra, Avijit
Kindo, Anupma Jyoti
Annamalai, Radha
Rudramurthy, Shivaprakash M.
Singh, Mini P.
Shameem, Mohammad
Fatima, Nazish
Khambholja, Janakkumar R.
Parikh, Sangita
Madkaikar, Manisha
Pradhan, Vandana D.
Kataria, Sushila
Sharma, Pooja
Panda, Samiran
A case control investigation of COVID-19 associated mucormycosis in India
title A case control investigation of COVID-19 associated mucormycosis in India
title_full A case control investigation of COVID-19 associated mucormycosis in India
title_fullStr A case control investigation of COVID-19 associated mucormycosis in India
title_full_unstemmed A case control investigation of COVID-19 associated mucormycosis in India
title_short A case control investigation of COVID-19 associated mucormycosis in India
title_sort case control investigation of covid-19 associated mucormycosis in india
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667849/
https://www.ncbi.nlm.nih.gov/pubmed/36384482
http://dx.doi.org/10.1186/s12879-022-07844-y
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