Back to Search Start Over

A case control investigation of COVID-19 associated mucormycosis in India

Authors :
Tanu Anand
Aparna Mukherjee
Aanchal Satija
Poonam Sharma Velamuri
Kh. Jitenkumar Singh
Madhuchhanda Das
Kripa Josten
Pragya D. Yadav
Rima R. Sahay
Archana Y Keche
Nitin M Nagarkar
Prashant Gupta
D. Himanshu Reddy
Sejal N. Mistry
Jimy D. Patel
Prajwal Rao
Shalesh Rohatgi
Soumitra Ghosh
Avijit Hazra
Anupma Jyoti Kindo
Radha Annamalai
Shivaprakash M Rudramurthy
Mini P Singh
Mohammad Shameem
Nazish Fatima
Janakkumar R. Khambholja
Sangita Parikh
Manisha Madkaikar
Vandana D. Pradhan
Sushila Kataria
Pooja Sharma
Samiran Panda
ICMR- Mucormycosis group ICMR-Mucormycosis group
Source :
BMC infectious diseases. 22(1)
Publication Year :
2022

Abstract

Background Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. Methods Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. Results CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. Conclusions Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts.

Details

ISSN :
14712334
Volume :
22
Issue :
1
Database :
OpenAIRE
Journal :
BMC infectious diseases
Accession number :
edsair.doi.dedup.....dfdb93117a5a0225e12ee4dfb05a90cd