Singla Neeraj, Sharma Nalin, Sharma Navneet, Behera Ashish, Bhatia Mandip
Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, IND.
Cureus. 2022 Sep 16;14(9):e29219. doi: 10.7759/cureus.29219. eCollection 2022 Sep.
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.
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.
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.
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.
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.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）席卷全球，绝大多数患者感染后会出现从轻度到危及生命的肺炎。在2019冠状病毒病（COVID-19）大流行的第二波期间，毛霉菌病在印度成为COVID-19的一种危及生命的并发症。在对该疾病的进展、毛霉菌病与COVID-19的关联以及各种诱发因素的理解方面存在很大空白。
评估在COVID-19大流行第二波期间，印度北部医院报告的毛霉菌病病例的模式、危险因素及结果。
对2021年5月至2021年7月因疑似或确诊毛霉菌病病史到医疗急诊就诊的109例患者进行了一项观察性前瞻性研究。使用描述性统计分析获得的数据，结果以百分比和均值表示。
109例患者中，男性75例，女性34例，平均年龄50.6岁，大多数病例来自农村地区。最常见的毛霉菌病类型为鼻眶型（34.8%）、鼻眶脑型（20.18%）和肺型（23.8%）。最常见的危险因素为糖尿病控制不佳（80%）、使用类固醇（68.8%）、糖尿病酮症酸中毒（42%）和COVID-19阳性状态（66.9%）。我们的研究中观察到高死亡率为33.9%。
我们研究中最脆弱的群体是有肺部表现的患者（51.4%）和需要吸氧治疗的患者（94.6%）。我们的研究发现，快速序贯器官衰竭评估（q SOFA）评分系统（p值<0.001）以及格拉斯哥昏迷量表（p值<0.038）可作为预后指标和早期疾病严重程度的良好评估工具。
