MUCORMYCOSIS IN COVID-19 AND NON COVID-19 PATIENTS: A COMPARATIVE CROSS SECTIONAL STUDY

Abstract

Background:

Recently, there have been a growing number of incidences of fungal infections, such as mucormycosis, in people with COVID-19 all over the world. The spread of Mucormycosis is very fast and delay in treatment could be fatal. This study compared Mucormycosis in COVID-19 patients versus non-COVID-19 patients.

Material and Methods:

This cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry Peshawar Pakistan from July 2021 to December 2021. A total of 50 cases of Mucormycosis were included by dividing into two groups. One of the groups had a positive history of COVID-19 infection while the second group had negative COVID-19 history. Diagnosis of Mucormycosis was confirmed on histopathology or fungal culture. For group 1, a history of COVID-19 infection was confirmed from patient records having positive COVID PCR within 2 months of the onset of Mucormycosis. For group 2, no COVID-19 infection was confirmed from the absence of signs and symptoms such as cough, fever,body achess and no contact with COVID-19-positive patient within 6 months of the onset of Mucormycosis. A logistic regression model was applied to determine the predictors of Mucormycosis while multi-logistic regression was run to see potential confounders.

Results:

Out of the total 50 patients,the  mean age of the patients was 50+9.45S.D. Steroids usage was high in COVID-19 positive patients [15 (60%),P value;0.001] while pus discharge was low 5(20%) in CoVID-19 patients in contrast toNon-COVID-199 Patients which was high[17 (68%):P value;0.001].

Multivariate Logistic regression analysis showed that the adjusted odds ratio (OR) for female patients was 2.74 (95 % CI 0.66-4.25) as compared to male patients. Similarly, patients with steroid use have about 3.58 times higher odds of catching the disease as compared to non-steroid use (95 % CI 1.066-19.3).  The OR for pus discharge was 0.40 (95 % CI 0.08-2.00), Left side 0.45 (95 % CI 0.06-2.9,) and Bilateral 0.93 (95 % CI 0.14-6.17).

Conclusion:

Covid-19 seems to havea  causal, coincidental or contributory role in the  development of Mucormycosis in the background of comorbidities such as diabetes. The role of Covid-19 needs to be specified and its association with Mucormycosis needs to be established. Furtherlarge-scalee studies are required where the association of COVID-19,the  role of dia,betethe s and use of steroids with the development of mucormycosis would be understood clearly.