Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India

Janardhanan, Rajiv ; Ponnaiah, Manickam ; Ganesan, Sivaraman ; Bhatnagar, Tarun ; Thulasingam, Mahalakshmy ; Majella, Marie Gilbert ; Karuppiah, Mathan ; Rizwan, S. A. ; Alexander, Arun ; Sarkar, Sonali ; Kar, Sitanshu Sekhar ; Kadhiravan, Tamilarasu ; Bhatnagar, Aparna ; S., Prasanna Kumar ; Pillai, Vivekanandan M. ; Nair, Pradeep Pankajakshan ; Dhodapkar, Rahul ; Ch Toi, Pampa ; Singh, Rakesh ; Kasthuri, Nirupama ; Kumar, Girish C. P. ; Jaisankar, Saranya ; Saini, Vaibhav ; Kankaria, Ankita ; Raj, Anuradha ; Goyal, Amit ; Sharma, Vidhu ; Khichar, Satyendra ; Soni, Kapil ; Garg, Mahendra Kumar ; Selvaraj, Kalaiselvi ; B. H., ShriKrishna ; Bhavana, Kranti ; Bharti, Bhartendu ; Singh, C. M. ; Chaudhary, Neha ; R., Vijayaravindh ; K., Gopinath ; Palaninathan, Karthikeyan ; Dube, Simmi ; Saxena, Rita Singh ; Gupta, Nikhil ; Rathinavel, A. ; Priya, S. ; Arulsundareshkumar, ; Bellad, Shama A. ; Kavi, Avinash ; Harugop, Anilkumar S. ; Pujary, Kailesh ; Ballala, Kirthinath ; Mallya, Sneha Deepak ; Prasad, Hanumanth M. ; Ravi, D. ; Balaji, N. K. ; Hegde, Raghuraj ; Mishra, Neha ; Ray, Shalina ; Karthikeyan, S. ; Ramalingam, Sudha ; Murali, A. ; Vaidya, Sudhakar ; Samadhiya, Mohit ; Bhojani, Dhaval ; Lakshmanan, Somu ; Singh, Sudagar R. B. ; Pillai, Nataraj ; Deepthi, P. ; Banumathi, K. ; Sumathi, V. ; Ramesh, D. ; Nissar, Sonam Poonam ; Sheikh, Khushnood M. ; Patel, Manisha N. ; Shristava, Vipul ; Kumar, Suresh S. ; Shantaraman, K. ; Pandian, Rajkamal D. ; Murhekar, Manoj ; Aggarwal, Rakesh (2022) Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India PLOS ONE, 17 (8). e0272042. ISSN 1932-6203

PDF
1MB

Official URL: http://doi.org/10.1371/journal.pone.0272042

Related URL: http://dx.doi.org/10.1371/journal.pone.0272042

Abstract

Background: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. Methods: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. Results: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. Conclusions: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.

Item Type:	Article
Source:	Copyright of this article belongs to Public Library of Science
ID Code:	129482
Deposited On:	23 Nov 2022 10:42
Last Modified:	23 Nov 2022 10:42

Repository Staff Only: item control page