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Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study

PURPOSE: Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19–associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for developing COVID-19–associated ROCM, comparing th...

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Autores principales: Karat, Shubashree, Lobo, Aaron C, Satish, Deepthi, Devaraj, Rincy, Manjooran, Riya R, Nithyanandam, Suneetha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672762/
https://www.ncbi.nlm.nih.gov/pubmed/35918980
http://dx.doi.org/10.4103/ijo.IJO_448_22
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author Karat, Shubashree
Lobo, Aaron C
Satish, Deepthi
Devaraj, Rincy
Manjooran, Riya R
Nithyanandam, Suneetha
author_facet Karat, Shubashree
Lobo, Aaron C
Satish, Deepthi
Devaraj, Rincy
Manjooran, Riya R
Nithyanandam, Suneetha
author_sort Karat, Shubashree
collection PubMed
description PURPOSE: Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19–associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for developing COVID-19–associated ROCM, comparing the risk factors among COVID-19 patients with and without ROCM. METHODS: This case–control study included all COVID-19–associated ROCM patients treated at our hospital from May 1 to July 30, 2021. Controls included age- and sex-matched COVID-19 patients without ROCM, who were treated during the same time (exact matching, in 1:2 ratio). Matched pair analysis using conditional logistic regression was performed to examine the association of various risk factors with the development of ROCM in COVID-19 patients. RESULTS: The study included 69 patients with COVID-19–associated ROCM and 138 age- and gender-matched controls. Epidemiologically, COVID-19–associated ROCM predominantly affected males (59/69, 85%), in their early 50s (mean 52 years), with 48% (33/69) of patients being from medical resource-constrained settings. On multivariate conditional logistic regression, elevated serum glycated hemoglobin (HbA1c) (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.03–1.78), blood glucose (OR = 1.008, 95% CI: 1.003–1.013), and C-reactive protein (CRP) (OR = 1.07, 95% CI: 1.02–1.17) were associated with increased odds of developing COVID-19–associated ROCM. Patients with undetected diabetes mellitus with increasing HbA1c (OR = 3.42, 95% CI: 1.30–9.02) and blood glucose (OR = 1.02, 95% CI: 1.005–1.03) (P = 0.02) had a higher probability of developing COVID-19–associated ROCM than patients with established DM. CONCLUSION: Uncontrolled DM evidenced by elevated HbA1c and blood glucose levels, exacerbated by COVID-19–induced proinflammatory state indicated by elevated CRP, is the principal independent risk factor for COVID-19–associated ROCM. Middle-aged males with undetected DM, from a resource-constraint setting, are particularly at risk.
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spelling pubmed-96727622022-11-19 Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study Karat, Shubashree Lobo, Aaron C Satish, Deepthi Devaraj, Rincy Manjooran, Riya R Nithyanandam, Suneetha Indian J Ophthalmol Special Focus, Oculoplasty, Original Article PURPOSE: Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19–associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for developing COVID-19–associated ROCM, comparing the risk factors among COVID-19 patients with and without ROCM. METHODS: This case–control study included all COVID-19–associated ROCM patients treated at our hospital from May 1 to July 30, 2021. Controls included age- and sex-matched COVID-19 patients without ROCM, who were treated during the same time (exact matching, in 1:2 ratio). Matched pair analysis using conditional logistic regression was performed to examine the association of various risk factors with the development of ROCM in COVID-19 patients. RESULTS: The study included 69 patients with COVID-19–associated ROCM and 138 age- and gender-matched controls. Epidemiologically, COVID-19–associated ROCM predominantly affected males (59/69, 85%), in their early 50s (mean 52 years), with 48% (33/69) of patients being from medical resource-constrained settings. On multivariate conditional logistic regression, elevated serum glycated hemoglobin (HbA1c) (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.03–1.78), blood glucose (OR = 1.008, 95% CI: 1.003–1.013), and C-reactive protein (CRP) (OR = 1.07, 95% CI: 1.02–1.17) were associated with increased odds of developing COVID-19–associated ROCM. Patients with undetected diabetes mellitus with increasing HbA1c (OR = 3.42, 95% CI: 1.30–9.02) and blood glucose (OR = 1.02, 95% CI: 1.005–1.03) (P = 0.02) had a higher probability of developing COVID-19–associated ROCM than patients with established DM. CONCLUSION: Uncontrolled DM evidenced by elevated HbA1c and blood glucose levels, exacerbated by COVID-19–induced proinflammatory state indicated by elevated CRP, is the principal independent risk factor for COVID-19–associated ROCM. Middle-aged males with undetected DM, from a resource-constraint setting, are particularly at risk. Wolters Kluwer - Medknow 2022-08 2022-07-29 /pmc/articles/PMC9672762/ /pubmed/35918980 http://dx.doi.org/10.4103/ijo.IJO_448_22 Text en Copyright: © 2022 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Special Focus, Oculoplasty, Original Article
Karat, Shubashree
Lobo, Aaron C
Satish, Deepthi
Devaraj, Rincy
Manjooran, Riya R
Nithyanandam, Suneetha
Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study
title Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study
title_full Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study
title_fullStr Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study
title_full_unstemmed Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study
title_short Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study
title_sort uncontrolled diabetes mellitus exacerbated by covid-19–induced inflammation is the risk factor for covid-19–associated rhino-orbito-cerebral mucormycosis: a matched pair case–control study
topic Special Focus, Oculoplasty, Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672762/
https://www.ncbi.nlm.nih.gov/pubmed/35918980
http://dx.doi.org/10.4103/ijo.IJO_448_22
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