Largest study of COVID-19-associated mucormycosis in India

A panel of 97 clinicians working in India have just released an expedited study looking at 2986 cases of COVID-19-associated rhino-orbital-cerebral mucormycosis (ROCM). This disease has reached epidemic proportion during India’s second wave of the COVID-19 pandemic and this large-scale study provides important insights into the pathogenesis and treatment of ROCM.

This paper outlines the symptoms of the disease and suggest a system of characterisation for the progressive stages of ROCM.

The key findings from this retrospective study are that the use of corticosteroids and the presence of diabetes mellitus are the most important predisposing factors in the development of COVID-19-associated ROCM.

The authors have also analysed the onset of symptoms post-COVID-19 and one of the take home messages from the research is that if a patient presents with red flag symptoms or comorbidities then they need to be followed up after treatment for COVID-19.

A & B Stage 2c rhino-orbital-cerebral mucormycosis. Clinical photographs showing palatal involvement with a visible black eschar.

The importance of using surgical procedures to clear the disease is also discussed, with 67% of patients in the study undergoing functional endoscopic sinus surgery/paranasal sinus debridement.

This ground-breaking research raises awareness symptoms and signs of ROCM and recommends the following for decreasing mortality:

• a high index of clinical suspicion in post-COVID-19 patients
• prompt diagnosis
• early initiation of treatment with amphotericin B
• aggressive surgical debridement of the paranasal sinuses and/or orbital exenteration.

You can access the full article here.

Largest study of COVID-19-associated mucormycosis in India

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