Article ; Online: Uncontrolled diabetes mellitus exacerbated by COVID-19-induced inflammation is the risk factor for COVID-19-associated rhino-orbito-cerebral mucormycosis: A matched pair case-control study.
Indian journal of ophthalmology
2022 Volume 70, Issue 8, Page(s) 3096–3101
Abstract: Purpose: Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for ... ...
| Abstract | Purpose: Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for developing COVID-19-associated ROCM, comparing the risk factors among COVID-19 patients with and without ROCM. Methods: This case-control study included all COVID-19-associated ROCM patients treated at our hospital from May 1 to July 30, 2021. Controls included age- and sex-matched COVID-19 patients without ROCM, who were treated during the same time (exact matching, in 1:2 ratio). Matched pair analysis using conditional logistic regression was performed to examine the association of various risk factors with the development of ROCM in COVID-19 patients. Results: The study included 69 patients with COVID-19-associated ROCM and 138 age- and gender-matched controls. Epidemiologically, COVID-19-associated ROCM predominantly affected males (59/69, 85%), in their early 50s (mean 52 years), with 48% (33/69) of patients being from medical resource-constrained settings. On multivariate conditional logistic regression, elevated serum glycated hemoglobin (HbA1c) (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.03-1.78), blood glucose (OR = 1.008, 95% CI: 1.003-1.013), and C-reactive protein (CRP) (OR = 1.07, 95% CI: 1.02-1.17) were associated with increased odds of developing COVID-19-associated ROCM. Patients with undetected diabetes mellitus with increasing HbA1c (OR = 3.42, 95% CI: 1.30-9.02) and blood glucose (OR = 1.02, 95% CI: 1.005-1.03) (P = 0.02) had a higher probability of developing COVID-19-associated ROCM than patients with established DM. Conclusion: Uncontrolled DM evidenced by elevated HbA1c and blood glucose levels, exacerbated by COVID-19-induced proinflammatory state indicated by elevated CRP, is the principal independent risk factor for COVID-19-associated ROCM. Middle-aged males with undetected DM, from a resource-constraint setting, are particularly at risk. |
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| MeSH term(s) | Antifungal Agents/therapeutic use ; Blood Glucose ; COVID-19/epidemiology ; Case-Control Studies ; Diabetes Mellitus/epidemiology ; Glycated Hemoglobin A ; Humans ; Inflammation ; Male ; Middle Aged ; Mucormycosis/diagnosis ; Mucormycosis/epidemiology ; Nose Diseases/drug therapy ; Orbital Diseases/drug therapy ; Risk Factors |
| Chemical Substances | Antifungal Agents ; Blood Glucose ; Glycated Hemoglobin A |
| Language | English |
| Publishing date | 2022-08-01 |
| Publishing country | India |
| Document type | Journal Article |
| ZDB-ID | 187392-1 |
| ISSN | 1998-3689 ; 0301-4738 |
| ISSN (online) | 1998-3689 |
| ISSN | 0301-4738 |
| DOI | 10.4103/ijo.IJO_448_22 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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