Study: Guj, Maha shared 43% ROCM-black fungus burden

Ahmedabad: Gujarat and Maharashtra – two states reporting the highest cases of mucormycosis (MM) after the second wave of Covid-19 – also reported highest cases of rhino-orbital-cerebral mucormycosis (ROCM), claimed a national study with 2,826 patients from 22 states and Union territories. The findings suggested 22% of India’s total ROCM recorded from Gujarat, followed closely by Maharashtra with 21%.

The study, ‘Epidemiology, clinical profile, management, and outcome of Covid-19 associated rhinoorbital cerebral mucormycosis in 2,826 patients in India – Collaborative OPAIIJO Study on Mucormycosis in Covid-19 (COSMIC)’ was published in the Indian Journal of Ophthalmology.

The study focused on the fungal infection spread in sinuses, space behind eyes and below the brain. The study added ROCM was primarily manifested by facial or eye pain (23%), swelling (edema) on face or near eyes (21%), and loss of vision (19%). The study includes doctors from Ahmedabad, Surat, Vadodara and Rajkot.

Dr Anuja Desai, an ophthalmologist with KD Hospital and one of the authors of the study, said the patient profile indicated older patients (average age of 52 years), more males (71%) than females, and 78% having diabetes as an existing comorbidity. “Out of diabetics, 41% reported diabetes. Moreover, 25% also reported having high blood pressure,” she said.

Other findings pointed at 57% of patients requiring oxygen support, and 87% of patients treated with corticosteroids. Most cases (56%) showed onset of ROCM between day 10 and 15 from start of Covid-19 infection. Mortality was found to be 14% among these patients.

Dr Bela Prajapati, head of the ENT department at Civil Hospital and member of the state committee on mucormycosis, said that Covid-19 infection remains the major factor for phenomenal increase in MM cases, and ROCM form a bulk of total cases, followed by infection in oral cavity. “At our hospital, there were two male patients for every one female patient treated. Majority of the patients were 40 years or above,” she said.