Background In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. Methods We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. Results Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45–59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. Conclusions Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.

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Venous ectasias are benign conditions of the neck, in which focal dilatations of veins occur. Internal jugular, external jugular or superficial veins are usually the affected ones in the neck. They are often ignored or misdiagnosed. Here we are reporting a patient with venous ectasia of the retromandibular vein and the common facial vein. A 25-year-old male presented to our out-patient department with an intermittent swelling over the right side of the neck that he had for one year. The swelling was more prominent on lying down and on Valsalva maneuver. Radiologic imaging was suggestive of venous ectasia of the retromandibu-lar vein and the common facial vein. Surgical excision was done for aesthetic reasons and in fear of thrombosis. Intraoperatively, we noticed that it was arising from the retromandibular and the common facial veins. Venous ectasias of superficial veins are rare. We can consider these patients for surgical excision in view of the risk of thrombosis, thromboembolic events, rupture, and aesthetic reasons.

Covid-19 pandemic is in a massive second wave in India. The new variant is considered more infectious. Diabetic patients are considered more vulnerable to develop some of the complications of acute Covid-19 infections. Furthermore, steroids are being used in the treatment of Covid-19 related pneumonia in a large number of patients. Hence, secondary fungal infections are being increasing observed, with very high mortality. We present the clinical, imaging and histopathological features in a diabetic patient who recovered from acute Covid-19 infection. However, he developed palatal and maxillary mucormycosis. Mucosal debridement, sinus surgery and antifungal treatment led to a satisfactory outcome.