Case Report: Rhino-orbital Mucormycosis Related to COVID-19: A Case Series Exploring Risk Factors

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  • 1 Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India;
  • | 2 Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India;
  • | 3 Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
  • | 4 Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India

There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycemia resulting from diabetes which is a common comorbidity in COVID-19 patients, and indiscriminate steroid use has resulted in this surge. We report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted to our center between mid-April and early June 2021. The cases showed a male preponderance, two patients had loss of vision, and four of them showed intracranial extension of disease. Twelve patients had received steroids and 12 had preexisting or newly diagnosed diabetes, both steroid use and diabetes being the most common identified risk factors. Considering other possible risk factors, immunosuppressed state, antiviral or ayurvedic (Indian traditional) medications, and oxygen therapy were not associated with a definite risk of mucormycosis, because they were not present uniformly in the patients. We propose that COVID-19 itself, through molecular mechanisms, predisposes to mucormycosis, with other factors such as dysglycemia or steroid use increasing the risk.

Author Notes

Address correspondence to Sankha Shubhra Chakrabarti, Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, PIN-221005 Email: sankha.chakrabarti1@bhu.ac.in or Sushil Kumar Aggarwal, Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, E-mail: sushildocims@bhu.ac.in.

Authors’ addresses: Sushil Kumar Aggarwal, Akshat Pandey, and Anshuman Singh, Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, E-mails: sushildocims@bhu.ac.in, akshatpandey@yahoo.co.in, and 1989anshumansingh@gmail.com. Upinder Kaur, Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, E-mail: upinder.kaur1@bhu.ac.in. Dolly Talda, Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, E-mail: talda.dolly041@gmail.com. Sumit Jaiswal, Ahalya Kanakan, and Sankha Shubhra Chakrabarti, Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, E-mails: sumit94.sj@gmail.com, ahalya11235@gmail.com, and sankha.geriatrics@gmail.com.

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