COVID-19 associated mucormycosis and diabetes mellitus: An exploratory study

Abd El-Hameed, Ayman R.; Abdelsalam, Noha M.; Saleh, Alaa Mohamed Ahmed; Awad, Ali Mohammad Mohammad; ElShabrawy, Arafa M.

doi:10.21608/mid.2022.122341.1248

COVID-19 associated mucormycosis and diabetes mellitus: An exploratory study

Document Type : Original Article

Authors

¹ Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt

² Department of Community Medicine, Faculty of Medicine, Zagazig University, Egypt

³ Department of Ophthalmology, Faculty of Medicine, Zagazig University, Egypt

⁴ Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt

⁵ Department of Internal medicine , Faculty of medicine, Zagazig University, Egypt

10.21608/mid.2022.122341.1248

Abstract

Background:Mucormycosis has abruptly increased in Egypt during the third wave of COVID-19 especially in patients with diabetes mellitus (DM). The aim of this study was to investigate the risk factors, clinical presentation and outcome of mucormycosis in COVID-19 patients with diabetes. Methods: Prospective cohort study was conducted on 72 COVID-19 patients with DM presented with mucormycosis at intensive care units and Ear, Nose, and Throat Department of Zagazig University Hospitals over a period of three months from May 2021 to August 2021. All participants were submitted to history taking, examination, laboratory investigation, radiological and histopathology and culture testing. Results: Post COVID-19 new-onset diabetes mellitus (NOD) was detected in 40% of studied patients. 72.2% of patients had poorly controlled diabetes. Majority of studied patients presented by rhino-orbital mucormycosis (90.3%) and about 86% of them were operated. Hundred percent of patients gave history of antibiotic use and also nearly 99.0% of them received corticosteroids, while only 1.4% of them received tocilizumab. There was statistically significant association between operated patients, hemoglobin (HB) level, lymphocyte count, neutrophil-lymphocyte ratio (NLR), and CRP level with disease prognosis. Conclusions: Poorly controlled DM and steroid use are the most important risk for post COVID-19 mucormycosis. Early surgical intervention carried better disease outcome.

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