Baseline findings among hospitalized mucormycosis patients: A multicentric ambispective cohort study in India

Mucormycosis is a relatively rare but serious fungal infection increasingly recognized for its poor prognosis and high mortality. Due to the COVID-19 pandemic, the incidence of mucormycosis reached high levels during 2021–2022 in India.

A study published in the journal Mycology and led by Dr. Rizwan Suliankatchi Abdulkader (Indian Council of Medical Research), established a multicentric ambispective cohort of patients hospitalized with mucormycosis across India and reported their baseline profile, clinical characteristics, and outcomes at discharge.

Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent (NIE/IHEC/202107-02), trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire.

At baseline, they recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness, or swelling of the face were the most common symptoms (73.3%).

Liposomal Amphotericin B was the most common drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9%, but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high.

"The study enhances our understanding of the disease, which could be applied to draw greater policy attention to the problem and develop effective public health strategies. The findings of this inquiry could guide clinicians in devising standard treatment protocols and strategies and identification of risk factors for mortality," Dr. Rizwan Suliankatchi Abdulkader said.