- Largest cohort study of Post-COVID-19 mucormycosis: A concerning report from India
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Hari Meshram, Vivek Kute, Himanshu Patel, Sanshriti Chauhan, Subho Banerjee, Ruchir Dave, Sudeep Desai
2021 ; 2021(1):
- 논문분류 :
- 춘계학술대회 초록집
Objective: We did a comprehensive analysis of 11 mucormycosis cases in kidney transplant recipients (KTR) who recovered from SARS-CoV2 (n = 335) in IKDRC, Ahmedabad, Gujarat, India during the study period from May 2020 to April 2021. Methods: The incidence of post-COVID-19 mucormycosis increased exponentially from 0.8% (2 of 225) in the first wave to 9% (10 of 110) in the second. The median age (interquartile range, range) of the cohort was 42(33.5-50, 26-60) years with 54.5% diabetes. COVID-19 severity ranged from mild (n=10) to severe cases (n=1). The duration from COVID-19 discharge to readmission was 7(7-7, 4-14) days. Ten cases were Rhino-orbital-cerebral-mucormycosis (ROCM) and one had pulmonary mucormycosis. Functional endoscopic sinus surgery (FESS) was performed in all cases of ROCM. The duration of antifungal therapy was 24(21-28.5, 17-40) days. The mortality rate reported was 27%. Results: To date, this represents the largest cohort of post-COVID-19 mucormycosis in transplantation. The morbidity and mortality with post-COVID-19 mucormycosis are high. Judicious use of steroids should be done along with strict control of blood sugars. Preparedness and early identification is the key to improve the outcomes. Conclusions: Objective: Severe acute respiratory syndrome coronavirus (SARS-CoV2) sequelae in the transplant population are scarcely reported. Mucormycosis is one of such sequelae, which was a rare entity before the pandemic. Methods: We did a comprehensive analysis of 11 mucormycosis cases in kidney transplant recipients (KTR) who recovered from SARS-CoV2 (n = 335) in IKDRC, Ahmedabad, Gujarat, India during the study period from May 2020 to April 2021. Results: The incidence of post-COVID-19 mucormycosis increased exponentially from 0.8% (2 of 225) in the first wave to 9% (10 of 110) in the second. The median age (interquartile range, range) of the cohort was 42(33.5-50, 26-60) years with 54.5% diabetes. COVID-19 severity ranged from mild (n=10) to severe cases (n=1). The duration from COVID-19 discharge to readmission was 7(7-7, 4-14) days. Ten cases were Rhino-orbital-cerebral-mucormycosis (ROCM) and one had pulmonary mucormycosis. Functional endoscopic sinus surgery (FESS) was performed in all cases of ROCM. The duration of antifungal therapy was 24(21-28.5, 17-40) days. The mortality rate reported was 27%. Conclusions: To date, this represents the largest cohort of post-COVID-19 mucormycosis in transplantation. The morbidity and mortality with post-COVID-19 mucormycosis are high. Judicious use of steroids should be done along with strict control of blood sugars. Preparedness and early identification is the key to improve the outcomes.