Mucor Alert: Triad of COVID-19, Corticosteroids Therapy and Uncontrolled Glycemic Index

Solanki, Bharti; Chouhan, Mahendra; Shakrawal, Neha

doi:10.1007/s12070-021-02801-8

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…Interestingly, none of our cases had any severe form of COVID, and none were admitted in the ICU or on ventilator for ARDS. Recently, there has been an alarming trend of mucormycosis seen in patients with COVID-19 in India (7) and has also been reported in various parts of the world (8). This is probably related to the steroid usage during the COVID-19 treatment, leading to high morbidity (9).…”

Section: Discussionmentioning

confidence: 99%

Invasive Fungal Sinusitis in Patients With Coronavirus Disease 2019 Seen in South India

Hema¹,

kumar²,

Shah³

2022

Journal of Neuro-Ophthalmology

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Background:Coronavirus disease 2019 (COVID-19) has a vast array of presentations and associations with neuro-ophthalmic diseases. There has been a recent surge in ophthalmic manifestations secondary to fungal sinus infections in India especially in diabetic patients who were given systemic steroids. We present our COVID-19–related cranial neuropathies presenting in our clinic.Methods:This is a retrospective case series of 10 patients affected with COVID-19 disease and who presented with cranial nerve palsies at the neuro-ophthalmic department of a tertiary eye care hospital in South India. An analysis of electronic medical records data was performed, including their comorbidities, symptoms, cranial nerves involved, ocular and neuroimaging findings, site of lesion, etiology, and prognosis.Results:Most of the patients (7 of 10) presented with multiple cranial nerve palsies (MCNP) with poor visual acuity. 2 of the 10 cases succumbed to death due to the intracranial involvement. All MCNP cases had uncontrolled diabetes with a history of systemic steroids, and neuroimaging of these cases showed sinusitis of varying severity most of which were suggestive of fungal invasive type.Conclusion:Our study emphasizes the need to screen for fungal involvement in COVID-19 cases presenting with MCNP especially on diabetic patients on systemic steroids so that an early diagnosis may reduce visual loss and mortality. Physicians treating COVID-19 cases need to be aware of this dreadful complication.

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Section: Discussionmentioning

confidence: 99%

Invasive Fungal Sinusitis in Patients With Coronavirus Disease 2019 Seen in South India

Hema¹,

kumar²,

Shah³

2022

Journal of Neuro-Ophthalmology

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“…Furthermore, lesser use of steroids may decrease the risk for hyperglycemia and mucormycosis in these individuals. [ 23 ] Less need for antiviral agents will also help in reducing the cost of therapy. Now with more studies confirming extra-pulmonary manifestations of SARS-CoV-2 infection, there is increasing evidence of evoking multi-organ dysfunction in addition to severe respiratory distress syndrome among the Covid-19 patients.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of SARS-CoV-2 Vaccination in Preventing Severe Illness and Death – Real-world Data from a Cohort of Patients Hospitalized with COVID-19

Sagiraju

Elavarasi

Gupta

et al. 2022

Indian Journal of Community Medicine

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Background: While long-term studies on the correlates of protection, vaccine effectiveness, and enhanced surveillance are awaited for SARS-CoV-2 vaccine, studies on breakthrough infections help understand the nature and course of this illness among vaccinated individuals and guide in public health preparedness. This study aims to compare the differences in the hospitalization outcomes SARS-CoV-2 infection of fully vaccinated individuals with with those of unvaccinated and partially vaccinated individuals. Materials and Methods: Single institution observational cohort study. This study compared the differences in clinical, biochemical parameters and the hospitalization outcomes of 53 fully vaccinated individuals with those of unvaccinated (1464) and partially vaccinated (231) individuals, among a cohort of 2,080 individuals hospitalized with SARS-CoV-2 infection. Descriptive statistics and propensity-score weighted multivariate logistic regression analysis adjusting for clinical and laboratory parameters were used to compare the differences and to identify factors associated with outcomes. Results: Completing the course of vaccination protected individuals from developing severe COVID-19 as evidenced by lower proportions of those with hypoxia, abnormal levels of inflammatory markers, requiring ventilatory support, and death compared to unvaccinated and partially vaccinated individuals. There were no differences in these outcomes among patients who received either vaccine type approved in India. Conclusions: Efforts should be made to improve the vaccination rates as a timely measure to prepare for the upcoming waves of this highly transmissible pandemic. Vaccination rates of the communities may also guide in the planning of the health needs and appropriate use of medical resources.

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“…2 In addition, hyperglycemia during COVID-19 also increases the expression of endothelial receptor GRP78 and increases free iron and polymorphonuclear (PMN) dysfunction which promotes angioinvasion. 6 CAM has a few rare manifestations and complications of mucormycosis. Osteomyelitis in mucormycosis is rare and has been reported usually following trauma or in immunosuppressed patients with diabetes or transplantation.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 associated mucormycosis with frontal bone osteomyelitis

Gupta¹,

Gupta²,

Goel³

et al. 2022

IJIRM

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During the coronavirus disease 2019 (COVID-19) pandemic, increasing cases of COVID-19 associated mucormycosis (CAM) have been reported. This may be attributed directly to the COVID-19 infection or the associated unrecognised uncontrolled hyperglycaemia compounded by the use of COVID-19 treatment strategies such as steroids and IL-6 inhibitors. As mucormycosis is one of the most rapidly progressing fungal infection, an early diagnosis and early appropriate management are of prime importance in reducing mortality. Rhino-orbital-cerebral and pulmonary mucormycosis have been the most common presentations of CAM. Osteomyelitis in mucormycosis is very rare, although a few cases of maxillary bone involvement have been reported with CAM. We report a very rare and challenging case of extensive frontal bone osteomyelitis in a patient with CAM with frontal sinusitis and without orbital or maxillary bone involvement.

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Mucor Alert: Triad of COVID-19, Corticosteroids Therapy and Uncontrolled Glycemic Index

Cited by 7 publications

References 29 publications

Invasive Fungal Sinusitis in Patients With Coronavirus Disease 2019 Seen in South India

Invasive Fungal Sinusitis in Patients With Coronavirus Disease 2019 Seen in South India

The Effectiveness of SARS-CoV-2 Vaccination in Preventing Severe Illness and Death – Real-world Data from a Cohort of Patients Hospitalized with COVID-19

COVID-19 associated mucormycosis with frontal bone osteomyelitis

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