Abstract
Objective: To document and analyse demographic data, clinical presentation, possible interventions for early clinical detection and management of post-COVID-19 rhino-orbito-cerebral mucormycosis (ROCM).
Method: 32 patients having history of SARS-CoV-2 infection with features of ROCM were observed in terms of their history, presenting features, clinical, microbiological examination, type of surgical intervention, surgical sites of involvement which were subsequently analyzed.
Results: The mean (± S.D.) age of patients was 57 ± 13 years. All patients were diabetic. Mean (± S.D.) time of onset of ROCM symptoms, since onset of COVID-19 symptoms was 18 (± 4) days. 12.5% patients were fully vaccinated. 78.1% patients received steroid therapy; 28.1% received high flow nasal oxygen. 87.5% patients had blurring of vision, 65.62% headache, 59.37% cheek and eyelid swelling, 50% proptosis, 46.87% ophthalmoplegia, 40.62% ptosis, 40.62% loss of sensation over cheek, 25% orbital pain. Examination of specimen with KOH mount revealed Mucor spp. in all patients. 87.5% patients underwent endoscopic sinus surgery with debridement with/without orbital clearance; 56.25% maxillectomy; 25% orbital exenteration. 87.5% patients had paranasal sinus involvement, 43.75% orbit sparing orbital apex, 68.75% orbit with orbital apex. 81.25% patients had involvement of pterygopalatine fossa±infratemporal fossa. 50% patients had disease in Vidian canal and pterygoid wedge. 25% of patients had involvement of palate and 56.25% cheek and eyelid soft tissues.
Conclusion: A judicious COVID treatment protocol, high index of suspicion, close monitoring of high-risk patients and early institution of treatment can prevent case severity and reduce mortality.
Keywords: COVID-19; Mucormycosis; Paranasal sinuses; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2., Mucormycosis, Paranasal sinuses, 【초록키워드】 Treatment, SARS-CoV-2, SARS-COV-2 infection, severity, oxygen, Intervention, surgical, headache, Symptoms, endoscopic sinus surgery, COVID, Features, management, Mucormycosis, Patient, Treatment protocol, Pain, age, disease, COVID-19 symptoms, patients, High-risk patients, Mucor, Paranasal sinuses, steroid, COVID-19 symptom, steroid therapy, Diabetic, orbital exenteration, surgical intervention, vision, examination, demographic data, specimen, suspicion, close monitoring, document, debridement, sensation, ophthalmoplegia, high-risk patient, Prevent, feature, palate, reduce mortality, soft tissues, blurring of vision, Orbital apex, cheek, maxillectomy, orbital pain, paranasal sinus, proptosis, ptosis, Vidian canal, ± S.D, analyzed, presenting, eyelid, fossa, nasal oxygen, 【제목키워드】 pandemic, addition,