Post Covid Mucormycosis Of Head And Neck Region: A Systematic Review
Keywords:Post Covid Mucormycosis, Covid – 19, Diabetes Mellitus, Blood Glucose.
AIMS & OBJECTIVES: With the second wave of COVID-19, the Indian mainland has seen a significant increase in mucormycosis infection in COVID-19 patients. The mortality linked with this fungal infection is developing as a matter of attention, as evidenced by numerous case reports/case series and institutional experiences. The goal of this study is to execute a systematic review of the literature to determine the attributes of patients with mucormycosis and COVID-19.
METHOD: We chose keywords to search the online resources of PubMed, Scopus, and Google Scholar from inception to June 20, 2021. We gathered all of the detailed facts from case reports/series of patients with Head and Neck Mucormycosis, as well as COVID-19 reports from around the world. Following that, we looked at the relationship between Post Covid Mucormycosis and Diabetes, Blood Glucose and HbA1c levels, most frequently used corticosteroids in those patients, orbital, oral, sino-nasal, rhino-cerebral clinical features, mean time of onset of mucormycosis, CT, MRI findings, most widely accepted histological test, treatment, type of amphotericin B frequently used, mortality rate, and survival of the patient.
RESULT: Mucormycosis has been reported in 214 persons with COVID-19, with the majority of cases coming from India (55.1%), where 149 patients had diabetes (69.6%), with a blood glucose level of 332.2mg/dl and HbA1c level of 10.85 percent. These individuals were often treated with Dexamethasone and Methylprednisolone during Covid infection. Mucormycosis developed on average after 13.5 days. Opthalmoplegia, Ptosis, and Vision Loss were the most prevalent orbital signs. Teeth loosening, necrosis, and black eschar on palate were the most common oral symptoms. Facial discomfort, swelling, numerous pus draining sinuses, headache, and nasal discharge were the most frequent Sino Nasal symptoms. Opacification/thickening of the mucosa of the maxillary, frontal, sphenoidal, and ethmoidal sinuses were the most prevalent CT findings. Fungal brain abscess, cavernous sinus thrombosis, and paranasal sinus mucosal illness were the main significant MRI findings. As far as histological tests concerned, KOH and PAS remain the most often performed ones. Most patients were treated with Liposomal Amphotericin B and surgical debridement. A 39.6% mortality rate and a 65.3% survival rate were recorded.
The current study compiles a list of all CAM/PCM patients who have been reported worldwide. The majority of the patients were reported from India, and most of them had a history of diabetes mellitus and had been given glucocorticoids to treat COVID-19, necessitating careful administration of this medication during the pandemic.
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