Insights from Surgically treated Post Covid Acute Invasive Fungal Rhino-Orbital sinusitis in Chandrapur Study (SPAROS): A Population Based study of Coronavirus Associated Mucormycosis (CAM) characteristics in India

Kasatwar, Aakash; Shukla, Ravindra; Rathod, Nivrutti; Nandanwar, Jayshri; Mishra, Divyangi; Dhobley, Akshay

doi:10.1016/j.ijregi.2022.08.005

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Diabetes seems to be associated with 66% of cases reported from India vs. 55% of cases from elsewhere [ 31 ]. Prevalence of diabetes seems to be anywhere from 55% to up to 100% in reported case series with CAM [ 25 – 27 , 29 , 32 – 34 ] and several case series reported new onset diabetes in subjects with no prior history of diabetes [ 25 – 28 , 35 , 36 ].…”

Section: Prevalence and Incidencementioning

confidence: 99%

“… Singh A Singh C, Joshi S et al [ 98 ] Scientific literature search and systematic review of published data till 5/2021 101 cases 82 cases from India 22-86 79% male Sinus 89%CNS involvement 22%, pulmonary 7.9% 80%, new onset diabetes 2.2% NA 76% Not reported 30.7% trinity of diabetes, rampant use of corticosteroid in a background of COVID-19 appears to increase mucormycosis. Kasatwar A, Shukla R, Rathod N et al [ 36 ] Observational study single district in, India of surgically treated patients with ROCM 3/2021-12/2021 100 cases 49.3 years 70% male Sinus or Rhinoorbital involvement only 95%, 52% with new onset diabetes NA 76% 95% 2% Incidence of 7.1/1000 patients noted in hospitalized patients with COVID-19 with steroid use and diabetes being the main risk factors, with increased GRP78 expression being postulated as underlying mechanism for infection Tavakolpour S, Irani S, Yekaninejad M et al [ 35 ] Retrospective observational case control study of single center in Iran 2/2020-9/2021 52 CAM 130 controls 57 years 63% male 100% ROCM Rhinoorbital 11.5%, sinus 34.6% and cerebral involvement 54% 55.8, new hyperglycemia 46% Severe COVID or need for O2 46% 88.5% Not reported 21.1 % mortality in CAM group CAM had higher odds of severe COVID (OR 3.6), prior diabetes (OR 7.37), smoking (OR 4.55), or receipt of high dose /pulse steroid therapy Dave T, Gopinathan Nair A, Hegde R et al [ 33 ] Retrospective multicentric observational case series of ROCM, India, 5/2021 58 56 years 76% male 100% ROCM 33% CNS extension 88% All patients had covid 19 infection, severity not reported 83% 100% 34% at mean 5.6 months follow up Uncontrolled DM, orbital apex involvement, CNS involvement and steroid use associated with unfavorable outcome. CNS involvement associated with risk of mortality Rao K, Pooja N [ 99 ] Observational study from ENT clinic, single center, India 180 40-60 years ...…”

Section: Prevalence and Incidencementioning

confidence: 99%

“…They seemed to have lower levels of hyperglycemia and less severe CAM disease with good prognosis. In contrast, the other group was of people with long standing diabetes with severe COVID who presented with more extensive disease needing more extensive surgery and with poorer outcomes [ 36 ]. They also described a series of patients with no steroid use or diabetes with a predilection of jaw involvement.…”

Section: Host Factorsmentioning

confidence: 99%

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Epidemiology of COVID-19–Associated Mucormycosis

Tayabali

Pothiwalla

Narayanan

2023

Curr Fungal Infect Rep

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Purpose of the Review To describe the epidemiology and risk factors for Coronavirus disease-19 (COVID-19)–associated mucormycosis (CAM) based on current published literature. Recent Findings COVID-19 is associated with an increased risk of secondary infections. Mucormycosis is an uncommon invasive fungal infection that typically affects people with immunocompromising conditions and uncontrolled diabetes. Treatment of mucormycosis is challenging and is associated with high mortality even with standard care. During the second wave of the COVID 19 pandemic, an abnormally high number of CAM cases were seen particularly in India. Several case series have attempted to describe the risk factors for CAM. Summary A common risk profile identified for CAM includes uncontrolled diabetes and treatment with steroids. COVID-19–induced immune dysregulation as well as some unique pandemic specific risk factors may have played a role.

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Section: Prevalence and Incidencementioning

confidence: 99%

Section: Prevalence and Incidencementioning

confidence: 99%

Section: Host Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology of COVID-19–Associated Mucormycosis

Tayabali

Pothiwalla

Narayanan

2023

Curr Fungal Infect Rep

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Ocular manifestations of COVID-19

Ng,

Scott,

Danesh-Meyer

et al. 2024

Progress in Retinal and Eye Research

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Proposed computed tomography severity index for the evaluation of invasive fungal sinusitis: Preliminary results

Manchanda,

Bhalla,

Nair

et al. 2024

World J Radiol

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BACKGROUND Invasive fungal sinusitis (IFS) can present as a mild disease to life-threatening infection. A recent surge in cases was seen due to the coronavirus disease 2019 (COVID-19) pandemic. Many patients require surgical debridement and hence imaging [contrast-enhanced computed tomography (CECT) of the paranasal sinuses (PNS)] to document the extent of the disease. However, there was no scoring system using CECT to describe the severity of IFS. This study proposes a computed tomography (CT) severity index (CTSI) to describe the severity of rhino-orbital-cerebral involvement in symptomatic COVID-19 patients and hypothesizes that higher CTSI correlates with disease severity and thus slow response/non-response to treatment. AIM To propose a scoring system using CECT to describe the severity of IFS and correlate it with clinical outcomes. METHODS A prospective study on 66 COVID-19 positive patients with CECT PNS done for IFS was performed. Split-bolus single-phase CT technique was used. Based on the extent of involvement, a CTSI was designed. Disease in four major subsite areas was assessed. Each subsite involvement was given points according to this model and then summated. Based on the final summated CTSI, the disease was classified as mild, moderate, or severe. Two subsets were subsequently analyzed including survival and death; and responders and non-responders. RESULTS The study cohort was 66 COVID-19-positive patients with suspected IFS with a median age of 48.5 years. Mild disease was noted in 34 (51.52%), moderate in 28 (42.42%), and severe disease in 4 (6.06%) patients. There was a significant association of mortality and poor clinical response (P = 0.02) with disease bilaterality. Laterality and CTSI were significant predictors of response to treatment. The mean CTSI of responders was 6.3, of non-responders was 12.9 and the response to treatment was significantly associated with CTSI (t -test, P < 0.001). Receiver operating characteristic curve analysis (Liu method) to distinguish between responders and non-responders showed that the cut-off value for CTSI of 11 had a sensitivity of 78.26% and a specificity of 95.35% to predict response assessment. CONCLUSION CTSI can help in quantification of the disease burden, mapping out disease extent, triaging patients, and response assessment; especially patients with underlying comorbidities. A higher score would alert the clinician to initiate aggressive treatment, as severe disease correlates with slow response/non-response to the treatment.

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Insights from Surgically treated Post Covid Acute Invasive Fungal Rhino-Orbital sinusitis in Chandrapur Study (SPAROS): A Population Based study of Coronavirus Associated Mucormycosis (CAM) characteristics in India

Cited by 3 publications

References 23 publications

Epidemiology of COVID-19–Associated Mucormycosis

Epidemiology of COVID-19–Associated Mucormycosis

Ocular manifestations of COVID-19

Proposed computed tomography severity index for the evaluation of invasive fungal sinusitis: Preliminary results

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