Krishna Prabha Premachandran, Pratik Savaj, Naresh Panda, Gayathri Devi Rajagopal, Riya Sandeep Parwani, Kamlesh Patel, Anuradha Deshmukh, Aruna Vyas, Srinivas Kishore Sistla, Priyadarshini A Padaki, Dharshni Ramar, Saurav Sarkar, Bharani Rachagulla, Pattabhiraman Vallandaramam, Immaculata Xess, Sunil Pawar, Piyush Gugale, Pradeep Hosamani, Sunil Narayan Dutt, Satish Nair, Hariprasad Kalpakkam, Sanjiv Badhwar, Kiran Kumar Kompella, Nidhi Singla, Milind Navlakhe, Amrita Prayag, Poorvesh Dhakecha, Jayanthi Savio, Arunaloke Chakrabarti, Ravindra Mehta, Gagandeep Singh, Puneet Saxena, Sudhir Bhandari, Valliappan Muthu, Shivaprakash Mandya Rudramurthy, Deepak Thangaraju, Manoj Radhakishan Shevkani, Atul K Patel, Prakash Srinivas Shastri, Ashwini Tayade, Vishwanath Gella, Ritesh Agarwal, Surabhi Madan, Vinay Kumar Hallur, Venkata Nagarjuna Maturu, Arjun Srinivasan, Nandini Sethuraman, Raminder Pal Singh Sibia, Sanjay Pujari, Tanu Singhal, Varsha Gupta, Vasant Nagvekar, Parikshit Prayag, Dharmesh Patel
Journal: Emerging infectious diseases 2022;29(1):8-19
PMID: 36573628
We performed a case–control study across 25 hospitals in India for the period of January–June 2021 to evaluate the reasons for an COVID-19–associated mucormycosis (CAM) outbreak. We investigated whether COVID-19 treatment practices (glucocorticoids, zinc, tocilizumab, and others) were associated with CAM. We included 1,733 cases of CAM and 3,911 age-matched COVID-19 controls. We found cumulative glucocorticoid dose (odds ratio [OR] 1.006, 95% CI 1.004–1.007) and zinc supplementation (OR 2.76, 95% CI 2.24–3.40), along with elevated C-reactive protein (OR 1.004, 95% CI 1.002–1.006), host factors (renal transplantation [OR 7.58, 95% CI 3.31–17.40], diabetes mellitus [OR 6.72, 95% CI 5.45–8.28], diabetic ketoacidosis during COVID-19 [OR 4.41, 95% CI 2.03–9.60]), and rural residence (OR 2.88, 95% CI 2.12–3.79), significantly associated with CAM. Mortality rate at 12 weeks was 32.2% (473/1,471). We emphasize the judicious use of COVID-19 therapies and optimal glycemic control to prevent CAM.
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