Rhino-orbital mucormycosis in a COVID-19 patient

Baskar, Harithraa Cheniappangoundar; Chandran, Aswin; Reddy, Chandra Shekar; Singh, Shruti

doi:10.1136/bcr-2021-244232

Cited by 21 publications

(11 citation statements)

References 8 publications

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“…Of these 28 included studies, 22 were case reports (describing single patients with individual data), two were case series (describing 7–42 patients with aggregate data), and four were cohort studies (describing 4–40 patients with aggregate data). Countries of study publication included the United States (n = 7) [ 7 , 9 , 21 – 25 ], Italy (n = 7) [ 26 – 32 ], Japan (n = 2) [ 33 , 34 ], Iran (n = 2) [ 35 , 36 ], the United Kingdom (n = 2) [ 37 , 38 ], Spain (n = 2) [ 39 , 40 ], Bahrain (n = 1) [ 41 ], China (n = 1) [ 42 ], France (n = 1) [ 43 ], the Philippines (n = 1) [ 44 ], Korea (n = 1) [ 45 ], and Canada (n = 1) [ 46 ], with publication dates ranging from April 15, 2020 to June 16, 2021. Table 1 describes the characteristics of these included studies and available information on their respective patient demographics in detail.…”

Section: Resultsmentioning

confidence: 99%

Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review

et al. 2021

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Background Endemic to the hospital environment, Staphylococcus aureus (S. aureus) is a leading bacterial pathogen that causes deadly infections such as bacteremia and endocarditis. In past viral pandemics, it has been the principal cause of secondary bacterial infections, significantly increasing patient mortality rates. Our world now combats the rapid spread of COVID-19, leading to a pandemic with a death toll greatly surpassing those of many past pandemics. However, the impact of co-infection with S. aureus remains unclear. Therefore, we aimed to perform a high-quality scoping review of the literature to synthesize the existing evidence on the clinical outcomes of COVID-19 and S. aureus co-infection. Methods A scoping review of the literature was conducted in PubMed, Scopus, Ovid MEDLINE, CINAHL, ScienceDirect, medRxiv, and the WHO COVID-19 database using a combination of terms. Articles that were in English, included patients infected with both COVID-19 and S. aureus, and provided a description of clinical outcomes for patients were eligible. From these articles, the following data were extracted: type of staphylococcal species, onset of co-infection, patient sex, age, symptoms, hospital interventions, and clinical outcomes. Quality assessments of final studies were also conducted using the Joanna Briggs Institute’s critical appraisal tools. Results Searches generated a total of 1922 publications, and 28 articles were eligible for the final analysis. Of the 115 co-infected patients, there were a total of 71 deaths (61.7%) and 41 discharges (35.7%), with 62 patients (53.9%) requiring ICU admission. Patients were infected with methicillin-sensitive and methicillin-resistant strains of S. aureus, with the majority (76.5%) acquiring co-infection with S. aureus following hospital admission for COVID-19. Aside from antibiotics, the most commonly reported hospital interventions were intubation with mechanical ventilation (74.8 %), central venous catheter (19.1 %), and corticosteroids (13.0 %). Conclusions Given the mortality rates reported thus far for patients co-infected with S. aureus and COVID-19, COVID-19 vaccination and outpatient treatment may be key initiatives for reducing hospital admission and S. aureus co-infection risk. Physician vigilance is recommended during COVID-19 interventions that may increase the risk of bacterial co-infection with pathogens, such as S. aureus, as the medical community’s understanding of these infection processes continues to evolve.

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Section: Resultsmentioning

confidence: 99%

Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review

et al. 2021

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“…Delayed initiation of therapy is associated with increased mortality. 22 , 23 Despite treatment, case‐fatality rates due to mucormycosis during the pre‐COVID‐19 pandemic era were already high, ranging from 32% to 70%, according to organ involvement. 22 , 23 However, in SARS‐CoV‐2 infection, the mortality maybe even higher.…”

Section: Introductionmentioning

confidence: 99%

“… 22 , 23 Despite treatment, case‐fatality rates due to mucormycosis during the pre‐COVID‐19 pandemic era were already high, ranging from 32% to 70%, according to organ involvement. 22 , 23 However, in SARS‐CoV‐2 infection, the mortality maybe even higher. Maximizing survival rates requires rapid diagnostic and therapeutic intervention, including immediate involvement of a multidisciplinary medical, surgical, radiological and laboratory‐based team.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, clinical presentation and management of COVID‐19 associated mucormycosis: A single centre experience from Pune, Western India

Dravid

Kashiva

Khan

et al. 2022

Mycoses

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Background The second COVID‐19 wave in India has been associated with an unprecedented increase in cases of COVID‐19 associated mucormycosis (CAM), mainly Rhino‐orbito‐cerebral mucormycosis (ROCM). Methods This retrospective cohort study was conducted at Noble hospital and Research Centre (NHRC), Pune, India, between 1 April, 2020, and 1 August, 2021, to identify CAM patients and assess their management outcomes. The primary endpoint was incidence of all‐cause mortality due to CAM. Results 59 patients were diagnosed with CAM. Median duration from the first positive COVID‐19 RT PCR test to diagnosis of CAM was 17 (IQR: 12,22) days. 90% patients were diabetic with 89% having uncontrolled sugar level (HbA1c >7%). All patients were prescribed steroids during treatment for COVID‐19. 56% patients were prescribed steroids for non‐hypoxemic, mild COVID‐19 (irrational steroid therapy), while in 9%, steroids were prescribed in inappropriately high dose. Patients were treated with a combination of surgical debridement (94%), intravenous liposomal Amphotericin B (91%) and concomitant oral Posaconazole (95.4%). 74.6% patients were discharged after clinical and radiologic recovery while 25.4% died. On relative risk analysis, COVID‐19 CT severity index ≥18 (p = .017), presence of orbital symptoms (p = .002), presence of diabetic ketoacidosis (p = .011) and cerebral involvement (p = .0004) were associated with increased risk of death. Conclusions CAM is a rapidly progressive, angio‐invasive, opportunistic fungal infection, which is fatal if left untreated. Combination of surgical debridement and antifungal therapy leads to clinical and radiologic improvement in majority of cases.

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“…The WHO database reflects the maximum number of reports related to Rhinoocular-cerebral infections. [11][12][13][14][15][16][17][18][19][20]…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, a significant number of studies were focused on orbital disease diagnosis and therapy. The WHO database reflects the maximum number of reports related to Rhinoocular-cerebral infections [11][12][13][14][15][16][17][18][19][20].…”

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confidence: 99%

Publications on Post-Covid Mucormycosis: A Bibliometric Study of WHO Database.

Sharma¹,

Dubey²

2021

Bangladesh J Med Sci

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Background: The COVID-19 pandemic has triggered a large number of publications to inform, understand, conduct more research and control the situation. Although the researchers are analyzing the bibliometrics on this condition, no bibliometric studies are available on the publications related to post-covid mucormycosis. This study is aimed at bibliometric assessment of the publications related to post-covid mucormycosis. Methods: In the presented study, authors have performed the bibliometric analysis of the World health organization (WHO) database named ‘Global literature on coronavirus disease.’ WHO is maintaining this database since the pandemic, and it contains thousands of reports. Two simple search terms, ‘Covid’ and ‘mucormycosis’ used to search the entire database in ‘title, abstract, subject’ mode with the search string was tw:(mucormycosis covid). The search was not restricted to any date range. Results: Only 51 reports (40 articles and 01 clinical trials) were obtained with the above search terms. The study found that there is considerable growth in such publication in the last 6 months. Interestingly only three such reports were published in the year 2020. Database wise 38 of these 51 reports were available in Medline. Most of such reports were published by Indian authors. Indian Journal of Ophthalmology emerged as the most productive journal contributing the highest number (10) of these reports. Conclusions: The highly acclaimed publications were the reviews. This study suggests that India is the most productive country for publications related to post-covid mucormycosis. This resembles the fact that the country, faced the excessive emergence of post-covid-19 mucormycosis cases reported the secondhighest number of Covid 19 cases in the substantial worldwide outbreak in the second wave, which is followed by post covid mucormycosis. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.144-147

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Rhino-orbital mucormycosis in a COVID-19 patient

Cited by 21 publications

References 8 publications

Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review

Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review

Epidemiology, clinical presentation and management of COVID‐19 associated mucormycosis: A single centre experience from Pune, Western India

Publications on Post-Covid Mucormycosis: A Bibliometric Study of WHO Database.

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