Absence of Case of Mucormycosis (March 2020–May 2021) under strict protocol driven management care in a COVID-19 specific tertiary care intensive care unit. Issue 4 (July 2021)

• Record Type: Journal Article
• Authors: Mulakavalupil, Bindu; Vaity, Charudatta; Joshi, Shashank; Misra, Anoop; Pandit, Rahul Anil
• Is Part Of: Diabetes & metabolic syndrome. Volume 15:Issue 4(2021)
• Publication Date: 2021-07
• Subjects: Mucormycosis -- Diabetes Mellitus -- Steroids -- Glycemic control -- protocol driven; Diabetes -- Periodicals; Metabolism -- Disorders -- Periodicals; Diabetes Mellitus -- Periodicals; Metabolic Diseases -- Periodicals; Diabète -- Périodiques; Métabolisme, Troubles du -- Périodiques; Endocrinologie -- Périodiques; Diabète -- Physiopathologie -- Périodiques; Diabetes; Metabolism -- Disorders; Electronic journals; Periodicals; 616.462
• DOI: 10.1016/j.dsx.2021.06.006
• Languages: English
• ISSNs: 1871-4021

Abstract

Abstract: Aims: With a sudden increase in cases of mucormycosis seen in Covid −19 patients, we conducted a retrospective analysis of all admitted patients in a tertiary care covid-19 hospital looking at incidence of mucormycosis. Methods: Intensive care unit daily rounds data stored in an electronic format was retrieved by one of the consultants, looking for incidence of mucormycosis, diabetes mellitus, adherence to protocol for steroid use, glycemic control and use of monoclonal antibodies. Also, patients follow up data base of post covid Outpatients Department was searched for cases of mucormycosis. Results: A total of 5248 patients were admitted between March 2020 to May 2021, of which 1027 were in ICU and 4221 in wards. Of the 1027 patients admitted in Intensive care unit, 915 received steroids and 417 had diabetes as existing co-morbidity. No case of mucormycosis was reported during the stay in the hospital and during immediate outpatient department follow up. The low dose steroids were administered as per state government protocol for treating COVID 19, a nurse driven strict glycemic control regime (blood glucose level was maintained between 140 and 180 mg/dl through the admission in ICU and was achieved consistently in 842 (82%) patients, followed along with minimal use of other immunomodulatory like monoclonal antibodies. Conclusion: A strict adherence to protocol of low dose steroids coupled with strict glycemic control helped in eliminating the risk and incidence of mucormycosis in a tertiary care dedicated covid-19 hospital. Highlights: 1. A total of 5248 patients with COVID-19 were admitted between March 2020 to May 2021, of which 1027 were in ICU and 4221 in wards. 2. Of the 1027 patients admitted in Intensive care unit, 915 received steroids and 417 had diabetes as existing co-morbidity. 3. No case of mucormycosis was reported during the stay in the hospital and during immediate follow up.