Table 1

Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India

Atul Patel¹, Ritesh Agarwal¹², Shivaprakash M. Rudramurthy, Manoj Shevkani, Immaculata Xess, Ratna Sharma, Jayanthi Savio, Nandini Sethuraman, Surabhi Madan, Prakash Shastri, Deepak Thangaraju, Rungmei Marak, Karuna Tadepalli, Pratik Savaj, Ayesha Sunavala, Neha Gupta, Tanu Singhal, Valliappan Muthu, Arunaloke Chakrabarti²

, and MucoCovi Network³

Author affiliations: Sterling Hospital, Ahmedabad, India (A Patel); Postgraduate Institute of Medical Education & Research, Chandigarh, India (R. Agarwal, S.M. Rudramurthy, V. Muthu, A. Chakrabarti); Avaron Hospital, Ahmedabad (M. Shevkani); All India Institute of Medical Science, New Delhi, India (I. Xess); Apollo Hospital, Hyderabad, India (R. Sharma); St. John’s Medical College, Bengaluru, India (J. Savio); Apollo Hospital, Chennai, India (N. Sethuraman); Care Institute of Medical Sciences, Ahmedabad (S. Madan); Sir Ganga Ram Hospital, New Delhi (P. Shastri); Kovai Medical Centre and Hospital, Coimbatore, India (D. Thangaraju); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (R. Marak); All India Institute of Medical Sciences, Bhopal, India (K. Tadepalli); Venus Hospital, Surat, India (P. Savaj); Hinduja Hospital, Mumbai, Maharashtra, India (A. Sunavala); Medanta The Medicity, Gurgaon, India (N. Gupta); Kokilaben Hospital, Mumbai, Maharashtra, India (T. Singhal)

Main Article

Baseline characteristics among patients with mucormycosis, with and without COVID-19, India*

Variables	CAM, n = 187	Non-CAM, n = 100	p value
Mean age, y (SD)	56.9 (12.5)	46.9 (16.4)	0.0001
Sex			0.003
M	150 (80.2)	64 (64.0)
F	37 (19.8)	36 (36.0)
Underlying disease			0.0001
None	0	19 (19.0)
COVID-19 only	61 (32.6)	0
Glucocorticoids for COVID-19	48/61 (78.7)	NA
Diabetes mellitus	113 (60.4)	67 (67.0)
Traumatic inoculation (dental surgery, trauma, and burns)	3 (1.6)	9 (9.0)
Hematological malignancy	2 (1.1)	2 (2)
Renal transplantation	3 (1.6)	0
Other†	5 (2.7)	3 (3)
Glucocorticoids	146 (78.1)	6 (6.0)	0.0001
Site of involvement
Rhino-orbital	117 (62.6)	50 (50.0)	0.07
Rhino-orbito-cerebral	44 (23.5)	34 (34.0)	0.07
Pulmonary	16 (8.6)	6 (6.0)	0.42
Renal	1 (0.5)	1 (1.0)	0.66
Other (e.g., cutaneous, stomach)	5 (2.7)	9 (9.0)	0.03
Disseminated	4 (2.1)	0	0.41
Microscopy			0.10
Negative smear	30 (16.0)	10 (10.0)
Aseptate hyphae	153 (81.8)	84 (84.0)
Septate hyphae	1 (0.5)	0
Septate and aseptate hyphae	3 (1.6)	6 (6.0)
Culture			0.04
No growth	87 (46.5)	61 (61.0)
Mucorales	99 (52.9)	37 (37.0)
Mucorales and Aspergillus species	1 (0.5)	1 (1.0)
Aspergillus species	0	1 (1.0)
Histopathology diagnostic of mucormycosis‡	143/155 (92.3)	37/44 (84.1)	0.10
Management and outcome
Hypoxemia during hospitalization	74 (39.6)	12 (12.0)	0.0001
Admission to the intensive care unit	58 (31.0)	9 (9.0)	0.0001
Treatment
Liposomal amphotericin B	136 (72.7)	84 (84)	0.002
Amphotericin D deoxycholate	31 (16.6)	5 (5.0)	0.005
Posaconazole	73 (39.0)	14 (14.0)	0.0001
Isavuconazole	19 (10.2)	2 (2.0)	0.01
Combined antifungal therapy			0.0001
Single antifungal drug	95 (50.8)	88 (88.0)
Concurrent	13 (7.0)	1 (1.0)
Sequential	79 (42.5)	11 (11.0)
Combined medical and surgical therapy	131 (70.1)	73 (73.0)	0.60
Outcome
Death <6 weeks	70 (37.4)	40 (40.0)	0.67
Death <12 weeks (n = 256)	75/170 (44.1)	42/86 (48.8)	0.51

*Values are no. (%) except as indicated. CAM, COVID-19–associated mucormycosis; COVID-19, coronavirus disease; NA, not applicable. †Includes liver cirrhosis, immunosuppression, and malignancies. ‡Histopathological examination was performed in 199 cases, 155 in the CAM group and 44 non-CAM groups.

Main Article

¹These first authors contributed equally to this article.

²These senior authors contributed equally to this article.

³Members are listed at the end of this article.

Page created: June 02, 2021

Page updated: August 17, 2021

Page reviewed: August 17, 2021

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