학술논문
Multicenter Case–Control Study of COVID-19–Associated Mucormycosis Outbreak, India
Document Type
article
Author
Valliappan Muthu; Ritesh Agarwal; 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; Arunaloke Chakrabarti
Source
Emerging Infectious Diseases, Vol 29, Iss 1, Pp 8-19 (2023)
Subject
Language
English
ISSN
1080-6040
1080-6059
1080-6059
Abstract
We performed a case–control study across 25 hospitals in India for the period of January–June 2021 to evaluate the reasons for an COVID-19–associated mucormycosis (CAM) outbreak. We investigated whether COVID-19 treatment practices (glucocorticoids, zinc, tocilizumab, and others) were associated with CAM. We included 1,733 cases of CAM and 3,911 age-matched COVID-19 controls. We found cumulative glucocorticoid dose (odds ratio [OR] 1.006, 95% CI 1.004–1.007) and zinc supplementation (OR 2.76, 95% CI 2.24–3.40), along with elevated C-reactive protein (OR 1.004, 95% CI 1.002–1.006), host factors (renal transplantation [OR 7.58, 95% CI 3.31–17.40], diabetes mellitus [OR 6.72, 95% CI 5.45–8.28], diabetic ketoacidosis during COVID-19 [OR 4.41, 95% CI 2.03–9.60]), and rural residence (OR 2.88, 95% CI 2.12–3.79), significantly associated with CAM. Mortality rate at 12 weeks was 32.2% (473/1,471). We emphasize the judicious use of COVID-19 therapies and optimal glycemic control to prevent CAM.