Rhino-orbital mucormycosis following COVID-19 in previously non-diabetic, immunocompetent patients
PURPOSE: To report a series of 13 immunocompetent patients who developed new-onset uncontrolled diabetes mellitus (DM) following COVID-19 infection and presented as rhino-orbital mucormycosis (ROM).
METHOD: Retrospective study.
RESULTS: A total of 127 patients of COVID-19 Associated Mucormycosis (CAM) were evaluated at four centres in India. All patients underwent endoscopic sinus debridement surgery and received systemic amphotericin-B therapy. Five patients (5/13; 38.4%) received retrobulbar amphotericin-B injections. Orbital exenteration was performed in advanced orbital involvement or progression of orbital disease in spite of maximal medical therapy. In his cohort, 13/127 (10.2%) patients presented with new onset DM, where one patient had bilateral disease. The mean age was 35.9 years (range: 20-51 years) and the mean duration from diagnosis of COVID-19 to the diagnosis of mucormycosis was 14.2 days. While 7/13 (53.8%) of the patients received systemic corticosteroids during the course of their treatment for COVID-19, six patients received no steroids or immunomodulators. The mean follow-up period was 9.2 weeks (range: 3-18 weeks) following discharge. Life salvage was possible in 100% of the cases. While overall globe salvage was possible in 42.8% (6/14 eyes), the globe could be preserved in 4/5 patients who received retrobulbar amphotericin-B injections.
CONCLUSIONS: Those involved in the care of COVID-19 patients should be aware about the possibility of recent-onset DM, even in patients without a history of corticosteroid therapy. Rarely, recent-onset DM following COVID-19 may present as rhino-orbital mucormycosis, which requires aggressive surgical and medical intervention.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
|---|---|
| Enthalten in: |
Orbit (Amsterdam, Netherlands) - 40(2021), 6 vom: 31. Dez., Seite 499-504 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Nair, Akshay Gopinathan [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Antifungal Agents |
|---|
| Anmerkungen: |
Date Completed 24.11.2021 Date Revised 26.04.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1080/01676830.2021.1960382 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM328826774 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM328826774 | ||
| 003 | DE-627 | ||
| 005 | 20231225203759.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/01676830.2021.1960382 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1096.xml |
| 035 | |a (DE-627)NLM328826774 | ||
| 035 | |a (NLM)34338124 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Nair, Akshay Gopinathan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rhino-orbital mucormycosis following COVID-19 in previously non-diabetic, immunocompetent patients |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.11.2021 | ||
| 500 | |a Date Revised 26.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: To report a series of 13 immunocompetent patients who developed new-onset uncontrolled diabetes mellitus (DM) following COVID-19 infection and presented as rhino-orbital mucormycosis (ROM) | ||
| 520 | |a METHOD: Retrospective study | ||
| 520 | |a RESULTS: A total of 127 patients of COVID-19 Associated Mucormycosis (CAM) were evaluated at four centres in India. All patients underwent endoscopic sinus debridement surgery and received systemic amphotericin-B therapy. Five patients (5/13; 38.4%) received retrobulbar amphotericin-B injections. Orbital exenteration was performed in advanced orbital involvement or progression of orbital disease in spite of maximal medical therapy. In his cohort, 13/127 (10.2%) patients presented with new onset DM, where one patient had bilateral disease. The mean age was 35.9 years (range: 20-51 years) and the mean duration from diagnosis of COVID-19 to the diagnosis of mucormycosis was 14.2 days. While 7/13 (53.8%) of the patients received systemic corticosteroids during the course of their treatment for COVID-19, six patients received no steroids or immunomodulators. The mean follow-up period was 9.2 weeks (range: 3-18 weeks) following discharge. Life salvage was possible in 100% of the cases. While overall globe salvage was possible in 42.8% (6/14 eyes), the globe could be preserved in 4/5 patients who received retrobulbar amphotericin-B injections | ||
| 520 | |a CONCLUSIONS: Those involved in the care of COVID-19 patients should be aware about the possibility of recent-onset DM, even in patients without a history of corticosteroid therapy. Rarely, recent-onset DM following COVID-19 may present as rhino-orbital mucormycosis, which requires aggressive surgical and medical intervention | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronavirus | |
| 650 | 4 | |a ROCM | |
| 650 | 4 | |a fungal sinusitis | |
| 650 | 4 | |a immunocompetent | |
| 650 | 4 | |a rhino-orbito-cerebral | |
| 650 | 7 | |a Antifungal Agents |2 NLM | |
| 700 | 1 | |a Adulkar, Namrata G |e verfasserin |4 aut | |
| 700 | 1 | |a D'Cunha, Lynn |e verfasserin |4 aut | |
| 700 | 1 | |a Rao, Priyanka R |e verfasserin |4 aut | |
| 700 | 1 | |a Bradoo, Renuka A |e verfasserin |4 aut | |
| 700 | 1 | |a Bapaye, Maneesh M |e verfasserin |4 aut | |
| 700 | 1 | |a Kothari, Abhishek |e verfasserin |4 aut | |
| 700 | 1 | |a Dave, Tarjani V |e verfasserin |4 aut | |
| 700 | 1 | |a Shinde, Chhaya A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Orbit (Amsterdam, Netherlands) |d 1994 |g 40(2021), 6 vom: 31. Dez., Seite 499-504 |w (DE-627)NLM08276090X |x 1744-5108 |7 nnns |
| 773 | 1 | 8 | |g volume:40 |g year:2021 |g number:6 |g day:31 |g month:12 |g pages:499-504 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/01676830.2021.1960382 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 40 |j 2021 |e 6 |b 31 |c 12 |h 499-504 | ||