Intraoperative Scoring Assessment as a Prognostic Tool in Covid-19 Associated Mucormycosis: A Short-Term Observational Study

Shenoy, Vijendra S; Bajpai, Sanchit; Kasaragod, Sreenivas Kamath

doi:10.1007/s12070-021-03015-8

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…In addition, studies including patients with invasive fungal infections in general, and not mucormycosis specifically, and studies including mucormycosis cases not associated with COVID-19 and not separately with CAM cases were excluded. Sixteen studies were excluded due to unavailable–insufficient information [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Four studies were excluded as they included patients with non-microbiologically confirmed SARS-CoV-2 infection [ 25 , 26 , 27 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

et al. 2022

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A mucormycosis surge was reported during the COVID-19 pandemic in India. A literature search until 14 July 2022, with the aim of updating COVID-19-associated mucormycosis (CAM), identified 663 studies and 88 met inclusion criteria (8727 patients). India reported 8388 patients, Egypt 208 and Europe 40. Rhino-orbito-cerebral mucormycosis (ROCM) was identified among 8082 (98.3%) patients, followed by 98 (1.2%) with pulmonary. In India, 82.6% of patients had diabetes mellitus, with 82% receiving corticosteroids. In Europe, 75% presented pulmonary CAM, 32.5% had diabetes and 40% were immunocompromised. CAM was identified at a median of 17.4 days (IQR 7.5 days) post COVID-19 diagnosis, and PCR was performed in five studies. Rhino-orbital invasion is clinically obvious, while cerebral involvement presents with cavernous sinus thrombosis, meningitis and cerebrovascular disease. Symptoms of pulmonary CAM usually overlap with severe COVID-19 pneumonia. High-dose liposomal Amphotericin B (and early surgical debridement in ROCM) are the mainstay of therapy. The median mortality rate was estimated to be 21.4% (IQR 31.9%), increased by the presence of pulmonary (80% (IQR 50%) or cerebral involvement (50% (IQR 63.9%). In summary, different CAM clinical phenotypes need to be distinguished, influenced by geographical presentation. Opportunities exist for diagnosis and therapy optimization, based on earlier high-dose antifungal therapy, early source control, strict glycemic control and restriction of steroids to COVID-19 patients with oxygen requirements.

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Section: Methodsmentioning

confidence: 99%

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

et al. 2022

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Intratemporal mucormycosis: a rare COVID-19 sequelae

et al. 2023

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A man in his 50s presented with a 2-month history of left ear discharge associated with hearing loss and weakness of left half of face since 15 days. The patient had no comorbidities, but he gave history of being treated for COVID-19 pneumonia 2 months ago post which he started experiencing left-sided aural symptoms. Clinical examination of ear revealed a subtotal perforation with multiple granulations in middle ear. Facial nerve examination revealed grade 3 lower motor neuron palsy. The biopsy of the granulations was sent to aid in diagnosis which later confirmed left ear mucormycosis. Otological involvement with facial palsy and sudden sensorineural loss in a patient with prior history of COVID-19 has not been reported until in literature. We try to communicate our experience to bridge the gap in understanding and managing this extremely rare occurrence of mucormycosis in the ear of a patient diagnosed with COVID-19 infection.

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Utility of intraoperative scoring system in rhino-orbital mucormycosis as a prognostic tool

Zuturu,

Shenoy,

Bajpai

et al. 2024

Acta Otorhinolaryngol Ital

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Summary Objective To assess the utility of an intraoperative scoring system for mucormycosis and to predict prognosis by comparing the score with postoperative outcomes. Methods This study was conducted among 80 patients with mucormycosis who underwent surgical management with mandatory pterygopalatine fossa and infratemporal fossa exploration. All cases were scored using our intraoperative scoring assessment tool. Postoperative outcomes in terms of favourable prognosis and mortality were evaluated and compared with demographics, clinical history and intraoperative findings. Results An intraoperative score of more than 25 was statistically significant in predicting mortality (p < 0.0001). In all, 86.7% of patients with a score above 25 succumbed to the disease. Statistical significance of mortality (p < 0.05) was observed in those with involvement of pterygopalatine fossa (78.9%), orbit (73.7%), infratemporal fossa (57.9%), cribriform plate (36.8%) and those with history of intake of antiviral drugs (47.4%), use of supplemental oxygen (31.6%) and renal failure (26.3%). Conclusions This study enabled better prediction of postoperative prognosis in mucormycosis and reiterated the importance of exploration of pterygopalatine fossa and infratemporal fossa in management and prognostication of invasive fungal sinusitis.

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Intraoperative Scoring Assessment as a Prognostic Tool in Covid-19 Associated Mucormycosis: A Short-Term Observational Study

Cited by 4 publications

References 18 publications

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

Intratemporal mucormycosis: a rare COVID-19 sequelae

Utility of intraoperative scoring system in rhino-orbital mucormycosis as a prognostic tool

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