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INCIDENCE OF SINO NASAL MUCORMYCOSIS IN ACTIVE & POST COVID- 19 PATIENTS AT A DISTRICT LEVEL HOSPITAL – A PROSPECTIVE STUDY
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  • Jitendra Singh,
  • R Arora,
  • Vijay Rawat,
  • Vikas Singh,
  • Snigdha Goyal,
  • Liza Joshi
Jitendra Singh
Civil Hospital, Sector 6, Panchkula, Haryana 134109

Corresponding Author:[email protected]

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R Arora
Civil Hospital Panchkula
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Vijay Rawat
Civil Hospital, Sector 6, Panchkula, Haryana 134109
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Vikas Singh
Civil Hospital Panchkula
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Snigdha Goyal
Civil Hospital Panchkula
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Liza Joshi
Civil Hospital Panchkula
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Abstract

Objective: To study the incidence of sinonasal mucormycosis in active and post COVID-19 patients in a district-level hospital in India. Study Design: A prospective, interventional cohort study conducted from April 2021 to January 2022. Setting: A district-level/secondary level hospital in North India. Methods: Inclusion Criteria: All COVID-19 positive patients with diabetes mellitus as co-morbidity and with at least one of the following:received steroid therapy and/or on high flow oxygen therapy and/or had prolonged hospital stay (>7 days). Exclusion Criteria: Patients already immunocompromised/having malignancy/organ transplant recipients. Clinical workup: History, examination, imaging (CECT/MRI nose and paranasal sinuses if indicated), diagnostic nasal endoscopy + Nasal scrapings for KOH mount to detect fungal elements. Results: Fourteen out of 250 patients tested positive for Mucormycosis (incidence 5.6%). Out of these 13 were symptomatic and only one patient was asymptomatic and detected on screening. No significant difference was found in mucormycosis vs. non-mucormycosis group with respect to HbA1c status, vaccination status or steroid + oxygen treatment (p>0.05 in all scenarios). Patients were treated with intravenous Liposomal Amphotericin B and surgical debridement when indicated. Two succumbed to disease (survival 85.7%). A clinical screening protocol was thus developed which can be used as an effective tool even at far-flung and remote healthcare facilities for diagnosis and timely referral of patients. Conclusion: Mucormycosis is a potentially lethal disease which needs rapid diagnosis and timely action to decrease morbidity and mortality.