Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients
Purpose: To estimate the pattern of ocular manifestations, as observed clinically and radiologically, and associated risk factors in cases of coronavirus disease 2019 (COVID-19)-related rhino-orbital cerebral mucormycosis (ROCM) during the second wave at presentation to the hospital in northern Indi...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Journal of Family Medicine and Primary Care |
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| Online Access: | https://journals.lww.com/10.4103/jfmpc.jfmpc_1161_24 |
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| author | Rajwinder Kaur Grace Budhiraja Upasana Bhumbla Manjot Kaur Vandana Sharma Priyanka Gupta Ritesh Singla Akashdeep Goel Ekta Gupta Priyanka Dahiya |
| author_facet | Rajwinder Kaur Grace Budhiraja Upasana Bhumbla Manjot Kaur Vandana Sharma Priyanka Gupta Ritesh Singla Akashdeep Goel Ekta Gupta Priyanka Dahiya |
| author_sort | Rajwinder Kaur |
| collection | DOAJ |
| description | Purpose:
To estimate the pattern of ocular manifestations, as observed clinically and radiologically, and associated risk factors in cases of coronavirus disease 2019 (COVID-19)-related rhino-orbital cerebral mucormycosis (ROCM) during the second wave at presentation to the hospital in northern India.
Materials and Methods:
A total of 35 patients of ROCM associated with active cases of COVID-19 or recovered cases of COVID-19 presenting to the Ophthalmology outpatient department or admitted in the COVID ward of the hospital with clinical features suggestive of ROCM. They were confirmed as mucormycosis on KOH and fungal cultures of nasal scrapings and histopathology of debrided tissue. This is an ambispective study with retrospective medical records review for COVID-19 analysis and prospective assessment of ROCM-associated COVID-19 during the second outbreak of the COVID-19 pandemic.
Results:
The total patients included were 35, which ranged in the age group of 52.91+/- 11.93 years, and the male-to-female ratio was 24:11. The duration between the first positive COVID report and onset of COVID-19-associated ROCM was 9.46+/-11.63 days. The majority (82.9%; n-29) either were diabetics or had high blood glucose levels during the recent COVID-19 infection. 45.7% of patients gave a history of steroid therapy. The most common ocular clinical features were ptosis (80%) and loss of vision 48.7%, respectively. There was diffuse involvement of sinuses in 18 cases (51.4%). Staging based on magnetic resonance imaging scans showed that 7 (20%) had stage II, 20 (57.1%) had stage III, and 28.7% had stage IV disease. Ten patients had varied intracranial extension ranging from meningitis and cavernous sinus thrombophlebitis/thrombosis to brain abscess.
Conclusions:
COVID-associated ROCM was very rapidly spreading and more destructive. Ptosis and loss of vision related to third nerve involvement and CRAO, respectively, were alarming signs and bad prognostic indicators to the patient. Intracranial involvement and CRAO were poor prognostic features in this type of mucormycosis. |
| format | Article |
| id | doaj-art-b50cd258d39246ac8498873933db767f |
| institution | Kabale University |
| issn | 2249-4863 2278-7135 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj-art-b50cd258d39246ac8498873933db767f2025-02-11T12:59:38ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352025-01-0114125926710.4103/jfmpc.jfmpc_1161_24Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patientsRajwinder KaurGrace BudhirajaUpasana BhumblaManjot KaurVandana SharmaPriyanka GuptaRitesh SinglaAkashdeep GoelEkta GuptaPriyanka DahiyaPurpose: To estimate the pattern of ocular manifestations, as observed clinically and radiologically, and associated risk factors in cases of coronavirus disease 2019 (COVID-19)-related rhino-orbital cerebral mucormycosis (ROCM) during the second wave at presentation to the hospital in northern India. Materials and Methods: A total of 35 patients of ROCM associated with active cases of COVID-19 or recovered cases of COVID-19 presenting to the Ophthalmology outpatient department or admitted in the COVID ward of the hospital with clinical features suggestive of ROCM. They were confirmed as mucormycosis on KOH and fungal cultures of nasal scrapings and histopathology of debrided tissue. This is an ambispective study with retrospective medical records review for COVID-19 analysis and prospective assessment of ROCM-associated COVID-19 during the second outbreak of the COVID-19 pandemic. Results: The total patients included were 35, which ranged in the age group of 52.91+/- 11.93 years, and the male-to-female ratio was 24:11. The duration between the first positive COVID report and onset of COVID-19-associated ROCM was 9.46+/-11.63 days. The majority (82.9%; n-29) either were diabetics or had high blood glucose levels during the recent COVID-19 infection. 45.7% of patients gave a history of steroid therapy. The most common ocular clinical features were ptosis (80%) and loss of vision 48.7%, respectively. There was diffuse involvement of sinuses in 18 cases (51.4%). Staging based on magnetic resonance imaging scans showed that 7 (20%) had stage II, 20 (57.1%) had stage III, and 28.7% had stage IV disease. Ten patients had varied intracranial extension ranging from meningitis and cavernous sinus thrombophlebitis/thrombosis to brain abscess. Conclusions: COVID-associated ROCM was very rapidly spreading and more destructive. Ptosis and loss of vision related to third nerve involvement and CRAO, respectively, were alarming signs and bad prognostic indicators to the patient. Intracranial involvement and CRAO were poor prognostic features in this type of mucormycosis.https://journals.lww.com/10.4103/jfmpc.jfmpc_1161_24covid-19manifestationocularrhino-orbital cerebral mycosis |
| spellingShingle | Rajwinder Kaur Grace Budhiraja Upasana Bhumbla Manjot Kaur Vandana Sharma Priyanka Gupta Ritesh Singla Akashdeep Goel Ekta Gupta Priyanka Dahiya Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients Journal of Family Medicine and Primary Care covid-19 manifestation ocular rhino-orbital cerebral mycosis |
| title | Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients |
| title_full | Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients |
| title_fullStr | Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients |
| title_full_unstemmed | Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients |
| title_short | Estimation of the pattern of ocular manifestations, risk factors, and imaging of rhino-orbital-cerebral mucormycosis in COVID-19 patients |
| title_sort | estimation of the pattern of ocular manifestations risk factors and imaging of rhino orbital cerebral mucormycosis in covid 19 patients |
| topic | covid-19 manifestation ocular rhino-orbital cerebral mycosis |
| url | https://journals.lww.com/10.4103/jfmpc.jfmpc_1161_24 |
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