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Volume 29, Number 1—January 2023
CME ACTIVITY - Synopsis

Multicenter Case–Control Study of COVID-19–Associated Mucormycosis Outbreak, India

Valliappan Muthu, Ritesh Agarwal1Comments to Author , Shivaprakash Mandya Rudramurthy, Deepak Thangaraju, Manoj Radhakishan Shevkani, Atul K. Patel, Prakash Srinivas Shastri, Ashwini Tayade, Sudhir Bhandari, Vishwanath Gella, Jayanthi Savio, Surabhi Madan, Vinay Kumar Hallur, Venkata Nagarjuna Maturu, Arjun Srinivasan, Nandini Sethuraman, Raminder Pal Singh Sibia, Sanjay Pujari, Ravindra Mehta, Tanu Singhal, Puneet Saxena, Varsha Gupta, Vasant Nagvekar, Parikshit Prayag, Dharmesh Patel, Immaculata Xess, Pratik Savaj, Naresh Panda, Gayathri Devi Rajagopal, Riya Sandeep Parwani, Kamlesh Patel, Anuradha Deshmukh, Aruna Vyas, Srinivas Kishore Sistla, Priyadarshini A Padaki, Dharshni Ramar, Saurav Sarkar, Bharani Rachagulla, Pattabhiraman Vallandaramam, Krishna Prabha Premachandran, Sunil Pawar, Piyush Gugale, Pradeep Hosamani, Sunil Narayan Dutt, Satish Nair, Hariprasad Kalpakkam, Sanjiv Badhwar, Kiran Kumar Kompella, Nidhi Singla, Milind Navlakhe, Amrita Prayag, Gagandeep Singh, Poorvesh Dhakecha, and Arunaloke Chakrabarti1
Author affiliations: Postgraduate Institute of Medical Education and Research, Chandigarh, India (V. Muthu, R. Agarwal, S.M. Rudramurthy, N. Panda, A. Chakrabarti); Kovai Medical Center and Hospital, Coimbatore, India (D. Thangaraju, G.D. Rajagopal); Avron Hospitals, Ahmedabad, India (M.R. Shevkani, R.S. Parwani); Sterling Hospital, Ahmedabad (A.K. Patel, K. Patel); Sir Gangaram Hospital, New Delhi, India (P.S. Shastri); Kingsway Hospital, Nagpur, India (A. Tayade, A. Deshmukh); Sawai Man Singh Medical College, Jaipur, India (S. Bhandari, A. Vyas); Asian Institute of Gastroenterology, Hyderabad, India (V. Gella, S.K. Sistla); St. John’s Medical College and Hospital, Bengaluru, India (J. Savio, P.A. Padaki); Care Institute of Medical Sciences, Ahmedabad (S. Madan, D. Ramar); All India Institute of Medical Science Bhubaneswar, Odisha, India (V.K. Hallur, S. Sarkar); Yashoda Hospitals, Hyderabad (V.N. Maturu, B. Rachagulla); Royal Care Hospital, Coimbatore (A. Srinivasan, P. Vallandaramam); Apollo Hospitals, Chennai, India (N. Sethuraman, K.P. Premachandran); Government Medical College, Patiala, India (R.P.S. Sibia, S. Pawar); Poona Hospital and Research Centre, Pune, India (S. Pujari, P. Gugale); Apollo Hospitals, Bengaluru (R. Mehta, H. Kalpakkam, P. Hosamani, S.N. Dutt, S. Nair); Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India (T. Singhal, S. Badhwar); Army Hospital (Research and Referral), New Delhi (P. Saxena, K.K. Kompella); Government Medical College, Chandigarh (V. Gupta, N. Singla); Global Hospital, Mumbai (V. Nagvekar, M. Navlakhe); Deenanath Mangeshkar Hospital, Pune (P. Prayag, A. Prayag); City Clinic and Bhailal Amin General Hospital, Vadodara, India (D. Patel); All India Institute of Medical Sciences, New Delhi (I. Xess, G. Singh); Institute of Infectious Disease and Critical Care Hospital, Surat, India (P. Savaj, P. Dhakecha)

Main Article

Table 2

Multivariate logistic regression analysis showing factors associated with CAM, India, January–June 2021*

Parameter Adjusted OR (95% CI) p value
Female sex
 0.92 (0.74–1.14)
 0.46
Rural residence
 2.88 (2.12–3.79)
 0.0001
Risk factor
No risk factor Referent
Diabetes mellitus 6.72 (5.45–8.28) 0.0001
Renal transplantation 7.58 (3.31–17.40) 0.0001
Others†
 1.20 (0.67–2.18)
 0.54
Presence of any comorbidity
 0.50 (0.39–0.63)
 0.0001
Hypoxia during COVID-19
 0.26 (0.21–0.32)
 0.0001
Diabetic ketoacidosis during COVID-19
 4.41 (2.03–9.60)
 0.0001
Cumulative glucocorticoid dose for COVID-19‡
 1.006 (1.004–1.007)
 0.0001
Zinc supplementation during COVID-19
 2.76 (2.24–3.40)
 0.0001
C-reactive protein at admission
 1.004 (1.002–1.006)
 0.0001
Serum ferritin, µg/L
 1.00 (1.00–1.00)
 0.21
Neutrophil-to-lymphocyte ratio 1.0 (0.99–1.01) 0.92

*CAM, COVID-19–associated mucormycosis. †Includes malignancies, hematological malignancies, immunosuppressive therapy, HIV, and others. ‡In milligram equivalent of dexamethasone.

Main Article

1These senior authors contributed equally to this article.

Page created: November 10, 2022
Page updated: December 19, 2022
Page reviewed: December 19, 2022
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