1. Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India.
- Author
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Ponnaiah M, Ganesan S, Bhatnagar T, Thulasingam M, Majella MG, Karuppiah M, Rizwan SA, Alexander A, Sarkar S, Kar SS, Kadhiravan T, Bhatnagar A, S PK, Pillai VM, Nair PP, Dhodapkar R, Ch Toi P, Singh R, Kasthuri N, Kumar GCP, Jaisankar S, Saini V, Kankaria A, Raj A, Goyal A, Sharma V, Khichar S, Soni K, Garg MK, Selvaraj K, B H S, Bhavana K, Bharti B, Singh CM, Chaudhary N, R V, K G, Palaninathan K, Dube S, Saxena RS, Gupta N, Rathinavel A, Priya S, Arulsundareshkumar, Bellad SA, Kavi A, Harugop AS, Pujary K, Ballala K, Mallya SD, Prasad HM, Ravi D, Balaji NK, Hegde R, Mishra N, Ray S, Karthikeyan S, Ramalingam S, Murali A, Vaidya S, Samadhiya M, Bhojani D, Lakshmanan S, Singh SRB, Pillai N, Deepthi P, Banumathi K, Sumathi V, Ramesh D, Nissar SP, Sheikh KM, Patel MN, Shristava V, Kumar SS, Shantaraman K, Pandian RD, Murhekar M, and Aggarwal R
- Subjects
- Antifungal Agents therapeutic use, Blood Glucose, Blood Glucose Self-Monitoring, Case-Control Studies, Hospitalization, Humans, India epidemiology, Middle Aged, Pandemics, COVID-19 epidemiology, Diabetes Mellitus drug therapy, Diabetes Mellitus epidemiology, Hyperglycemia complications, Hyperglycemia drug therapy, Hyperglycemia epidemiology, Mucormycosis drug therapy, Mucormycosis epidemiology, Orbital Diseases drug therapy
- Abstract
Background: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India., Methods: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model., Results: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM., Conclusions: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2022
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