Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India

Manickam Ponnaiah, Sivaraman Ganesan, Tarun Bhatnagar, Mahalakshmy Thulasingam, Marie Gilbert Majella, Mathan Karuppiah, S. A. Rizwan, Arun Alexander, Sonali Sarkar, Sitanshu Sekhar Kar, Tamilarasu Kadhiravan, Aparna Bhatnagar, Prasanna Kumar S, Vivekanandan M. Pillai, Pradeep Pankajakshan Nair, Rahul Dhodapkar, Pampa Ch Toi, Rakesh Singh, Nirupama Kasthuri, Girish C.P. KumarSaranya Jaisankar, Vaibhav Saini, Ankita Kankaria, Anuradha Raj, Amit Goyal, Vidhu Sharma, Satyendra Khichar, Kapil Soni, Mahendra Kumar Garg, Kalaiselvi Selvaraj, Shri Krishna B H, Kranti Bhavana, Bhartendu Bharti, C. M. Singh, Neha Chaudhary, Vijayaravindh R, Gopinath K, Karthikeyan Palaninathan, Simmi Dube, Rita Singh Saxena, Nikhil Gupta, A. Rathinavel, S. Priya, Arulsundareshkumar, Shama A. Bellad, Avinash Kavi, Anilkumar S. Harugop, Kailesh Pujary, Kirthinath Ballala, Sneha Deepak Mallya, Hanumanth M. Prasad, D. Ravi, N. K. Balaji, Raghuraj Hegde, Neha Mishra, Shalina Ray, S. Karthikeyan, Sudha Ramalingam, A. Murali, Sudhakar Vaidya, Mohit Samadhiya, Dhaval Bhojani, Somu Lakshmanan, Sudagar R.B. Singh, Nataraj Pillai, P. Deepthi, K. Banumathi, V. Sumathi, D. Ramesh, Sonam Poonam Nissar, Khushnood M. Sheikh, Manisha N. Patel, Vipul Shristava, Suresh S. Kumar, K. Shantaraman, Rajkamal D. Pandian, Manoj Murhekar, Rakesh Aggarwal

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12 Citations (Scopus)

Abstract

BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.

Original languageEnglish
Article numbere0272042
Pages (from-to)e0272042
JournalPLoS One
Volume17
Issue number8 August
DOIs
Publication statusPublished - 08-2022

All Science Journal Classification (ASJC) codes

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