International Journal of Health and Clinical Research
Yazarlar: Abha Kumari, Sandeep Kumar, Charumathi A
Konular:-
Anahtar Kelimeler:COVID,9,Ssociated mucormycosis,Rhino,Orbital,Cerebral mucor,Ycosis,Invasive fungal infection,Systemic corticosteroid therapy.
Özet: Background: Mucormycosis is a life-threatening angio-invasive fungal infection mostly observed in patients with uncontrolled Diabetes-mellitus and immune compromised patients. Mucormycosis progress rapidly and destructive in nature. The aim of our study is to analyse whether systemic steroid therapy is the contributing factor for COVID-19 associated Mucormycosis. Methods : We have 25 patients who were admitted to mucor-mycosis ward in Rajendra Institute of Medical Sciences, Ranchi. Data regarding age, sex of the patient, history of COVID-19 infection, history of diabetes mellitus, duration of diabetes mellitus and history pertaining to systemic steroid therapy during COVID-19 infection (type and dose of steroid given, duration of treatment), blood sugar level and HbA1C of the patients were also included in the study. Result: All our 25 patients were COVID-19 infected. 23(92%) were Male and 2(8%) were female patient. The most common affected age group was between 41-50 years (12,44%). 14(56%), 9(36%) and 2(8%) patients were known case of type 2 diabetes mellitus, newly diagnosed case of DM, and non-diabetic respectively. Among the 23 diabetic, 17(74%) had poor glycaemic control. 21(84%) patients out 25 received systemic corticosteroid therapy as a part of standard treatment of COVID-19 infection. The common steroid used in our study group was Dexamethasone administered via the intravenous route with an average dose of 12.3 per day in 18(86%) patients. Methylprednisolone was prescribed for 4(20%) patients with dose of 0.5-1mg/kg/day per orally. For 6(29%), 11(52%) and 4(19%)patients, steroid was administrated for a duration of <10days, 10-19 days,>20 days respectively. Conclusion: The immune dysregulation and hyperglycaemic state due to the COVID-19 infection, diabetes mellitus and systemic steroid therapy caused the epidemic outbreak of mucor-mycosis cases. This dreadful situation can be overcome by administrating glucocorticoid at possible lowest dose for shortest duration on alternate days and by maintaining proper glycaemic control of COVID-19 infected patient on systemic steroid therapy.