Study of hba1c and serum ferritin levels in covid 19 associated Mucor mycosis.

UNLABELLED

India witnessed a huge surge in Covid 19 cases in the second wave. There was also an increased presentation of Mucor mycosis cases associated with Covid 19 illness. Severe COVID-19 is a hyper-ferritinemic syndrome, but whether high ferritin is a marker of a severe systemic disease versus a modulator of pathophysiology is not known. Irrespective of its role, high ferritin levels lead to excess intracellular iron that generates reactive oxygen species resulting in tissue damage. There are many theories existing presently to associate the development of Mucor mycosis in Covid 19 patients. The present study is to evaluate the correlation between HbA1c and serum ferritin levels in COVID 19 associated Mucor mycosis and the associated outcomes.

MATERIAL

It is prospective observational study. RT-PCR confirmed cases of COVID 19 pneumonia with clinical, microbiological or radiologically confirmed cases of mucor mycosis were selected after obtaining informed consent. Relevant clinical data collected, Serum Hba1c and Ferritin was sent. Data analysis was done using SPSS software.

OBSERVATION

Among the 97 patients, 63 (64.9 %) were male and 34 (35.1%) were females, 10 (10.3 %) patients had no comorbidities, 82 (84.5 %) patients had diabetes mellitus, 32 (33.0 %) patients had hypertension and 30 (30.9 %) patients had both diabetes and hypertension. Mean Hba1c among the patients was 10.98 %. Mean serum ferritin level was 929.11 ng/dl. Mean Serum ferritin was significantly lower among survivors (843.8 ng/dl) when compared to non survivors (1150.2 ng/dl) (p= 0.034).

CONCLUSION

Serum ferritin is significantly elevated in COVID-19- associated mucor mycosis (CAMCR) cases. The mean Hba1c of 10.98 % suggests a background of poorly controlled diabetes mellitus along with COVID 19 infection is a risk factor for mucor mycosis. Serum ferritin was significantly lower among survivors when compared to non survivors. Increased serum ferritin can be associated with poor prognosis and mortality in COVID-19 associated mucor mycosis.

© Journal of the Association of Physicians of India 2011.