Bangalore Medical College and Research Institute, Bangalore.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
India witnessed a huge surge in Covid 19 cases in the second wave. There was also an increased presentation of Mucor mycosis cases associated with Covid 19 illness. Severe COVID-19 is a hyper-ferritinemic syndrome, but whether high ferritin is a marker of a severe systemic disease versus a modulator of pathophysiology is not known. Irrespective of its role, high ferritin levels lead to excess intracellular iron that generates reactive oxygen species resulting in tissue damage. There are many theories existing presently to associate the development of Mucor mycosis in Covid 19 patients. The present study is to evaluate the correlation between HbA1c and serum ferritin levels in COVID 19 associated Mucor mycosis and the associated outcomes.
It is prospective observational study. RT-PCR confirmed cases of COVID 19 pneumonia with clinical, microbiological or radiologically confirmed cases of mucor mycosis were selected after obtaining informed consent. Relevant clinical data collected, Serum Hba1c and Ferritin was sent. Data analysis was done using SPSS software.
Among the 97 patients, 63 (64.9 %) were male and 34 (35.1%) were females, 10 (10.3 %) patients had no comorbidities, 82 (84.5 %) patients had diabetes mellitus, 32 (33.0 %) patients had hypertension and 30 (30.9 %) patients had both diabetes and hypertension. Mean Hba1c among the patients was 10.98 %. Mean serum ferritin level was 929.11 ng/dl. Mean Serum ferritin was significantly lower among survivors (843.8 ng/dl) when compared to non survivors (1150.2 ng/dl) (p= 0.034).
Serum ferritin is significantly elevated in COVID-19- associated mucor mycosis (CAMCR) cases. The mean Hba1c of 10.98 % suggests a background of poorly controlled diabetes mellitus along with COVID 19 infection is a risk factor for mucor mycosis. Serum ferritin was significantly lower among survivors when compared to non survivors. Increased serum ferritin can be associated with poor prognosis and mortality in COVID-19 associated mucor mycosis.
评估 COVID-19 相关毛霉病患者的糖化血红蛋白(HbA1c)和血清铁蛋白水平之间的相关性以及相关结局。
这是一项前瞻性观察性研究。在获得知情同意后,选择 RT-PCR 证实的 COVID-19 肺炎病例,并结合临床、微生物学或放射学证实的毛霉病病例。收集相关临床数据,送检血清 Hba1c 和铁蛋白。使用 SPSS 软件进行数据分析。
在 97 例患者中,63 例(64.9%)为男性,34 例(35.1%)为女性,10 例(10.3%)无合并症,82 例(84.5%)患有糖尿病,32 例(33.0%)患有高血压,30 例(30.9%)同时患有糖尿病和高血压。患者的平均 HbA1c 为 10.98%。平均血清铁蛋白水平为 929.11ng/dl。与非幸存者(1150.2ng/dl)相比,幸存者(843.8ng/dl)的血清铁蛋白水平显著较低(p=0.034)。
COVID-19 相关毛霉病(CAMCR)患者的血清铁蛋白显著升高。平均 HbA1c 为 10.98%,提示在 COVID-19 感染的背景下,糖尿病控制不佳是毛霉病的危险因素。与非幸存者相比,幸存者的血清铁蛋白水平显著较低。血清铁蛋白升高与 COVID-19 相关毛霉病的不良预后和死亡率相关。