Diabetes and Covid Associated Mucormucormycosis-A Cross Sectional Study in Kilpauk Medical College.

UNLABELLED

To find the association between CAM and diabetes and correlate the severity of glycemic status,and clinical features and morbidity associated with them.

MATERIAL

This descriptive study was conducted at a COVID Ward in govt kilpauk med college from Apr 10, 2021 to Aug 1 0, 2021. All laboratory confirmed COVID-19 cases by RTPCR (Real Time Reverse Transcription Polymerse Chain Reaction) nasopharyngeal & throat swab were admitted at this centre. Severe COVID-19 infection was defined bySp02<90%orRespiratory rate >30/min at admi during hospital stay. Post COVID 19 cases were defined who had either clinical recovery from respiratory symptoms or had passed 28 days since the onset of symptoms of COVID 19. Lymphocytopenia was defined by absolute lymphocyte count<1000/mm3.Data compiled in Ms-excel sheet and studied.

OBSERVATION

In Patients with CAM30/32(93.8%) hadheadache,20/32(62.5%) had nasal symptoms in form of rhinorrhoea & nasal stuffiness and 19/32(59.4%) had eyes symptoms in form of red nessoreye pain. O n admission, 18/32 (56.2%) patients had history or presented with Severe COVID-19 pneumonia. At the time of diagnosis of CAM, 22/ 32 (68.8%) had hypoxemia and required supplemental oxygen. The mean duration from onset of COVID-19 to diagnosis of CAM was 17.28 (±11.76) days. In patients with CAM, none of them were fully vaccinated against COVID-19. Two patients had received a single dose of (Covishield) COVID-19 vaccine. Both the patients are still admitted at our centre and are on antifungal therapy. Among 822 hospitalized patients with COVID 19 infection, 36 patients had CAM with an incidence of 3.9%. In patients with CAM, 84.5% had Diabetes Mellitus as the most common co-morbidity. The majority of the patients had poor glycemic control with a mean HbA1c of 8.06%. Out of the total population, 88% had prior exposure to high dose corticosteroids.surgical debridement done for 65%of patients and others treated withantifungals. During the study period, 36% patients of CAM did not survive.

CONCLUSION

Mucormycosis is a formidable angioinvasive opportunistic infection in an immunocompromised host. The spectrum of mucormycosis involves rhino-orbital-cerebral, pulmonary, disseminated, cutaneous, gastrointestinal and disseminated form of disease. The major risk factors for the disease are diabetes, neutropenia, iron overload, malignancy and organ transplant. Diabetes is the most common metabolic disorder and is an independent risk factor for Severe COVID-19 and Mucormycosis. In patients with diabetes affected with COVID-19 superinfection with Mucormycosis will lead to adverse clinical outcome and prolonged hospital stay.