Covid-19 associated Rhino-oculo-cerebral mucormycosis: A radiological study at a tertiary care centre

Objective: Rhino-oculo-cerebral mucormycosis (ROCM) was on a rise during the second wave of the Covid-19 pandemic. The objective was to study the demographics of covid-19 associated ROCM, utilize radiological imaging as a tool to study the involvement of Paranasal Sinuses and its correlation with the pneumatisation and anatomical variations. Method: This is a retrospective study done after obtaining Scientific and Ethical Committee approval. The radiological findings regarding pneumatization and anatomical variations were studied along with the radiological involvement, severity, and treatment outcomes. Statistical analysis was performed using SPSS Software. Results: Majority of the patients affected with Covid-19 associated ROCM were males (86 %) with a mean age of 47 years. 91 % of the patients had diabetes as comorbidity with a mean HbA1c of 11.5. Severe form of the disease was seen in 16 % of the patients. The most common paranasal sinus to get involved was maxillary sinus (84 %). Orbital involvement was seen in 26 % of the patients. There was a moderate positive correlation between Clinical Grading and Average Involvement Score, and this correlation was statistically significant (rho = 0.59, p = <0.001). The overall case-fatality rate was 37 %. Conclusion: Poorly controlled diabetic patients infected with covid-19 needs to be aware of mucormycosis and any facial pain in such patients must be thoroughly evaluated. The mean duration between covid-19 infection and the onset of ROCM symptoms was around two weeks. The extent of involvement had clinically significant correlation, but pneumatization and anatomical variation did not influence the severity or outcome of treatment.