Airway management, procedural data, and in-hospital mortality records of patients undergoing surgery for mucormycosis associated with coronavirus disease (COVID-19)

Sirohiya, Prashant; Vig, Saurabh; Mathur, Tanmay; Meena, Jitendra Kumar; Panda, Smriti; Goswami, Gitartha; Gupta, Raghav; Konkimalla, Abhilash; Kondamudi, Dheeraj; Gupta, Nishkarsh; Ratre, Brajesh Kumar; Singh, R. A.; Kumar, Balbir; Pandit, Anuja; Sikka, Kapil; Thakar, Alok; Bhatnagar, Sushma

doi:10.1016/j.mycmed.2022.101307

Cited by 4 publications

(8 citation statements)

References 25 publications

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“…The incidence of difficult airways (36.9%) reported in the literature is in line with our study data [ 7 , 9 , 11 ]. In our study, 88% of patients were extubated after surgery in the operation theatre, and the remaining patients required prolonged mechanical ventilation in ICU due to post-COVID pulmonary sequelae, which was consistent with the findings reported by Karaaslan [ 10 ] and Sirohiya et al [ 11 ] Initially, only 11.9% patients shifted to ICU post-operatively, and there were 27.5% patients who required re-intubation in the ward and were shifted to ICU later. The mean duration of hospital stay and ICU is consistent with the findings reported by Solanki et al [ 9 ] and Karaaslan [ 10 ].…”

Section: Discussionsupporting

confidence: 93%

“…In our study, mortality occurred in 42 (48.27%) patients during the hospital stay, which was consistent with the literature (Dave et al [ 15 ] reported a mortality rate of 34%, Choksi et al [ 16 ] reported 10-day mortality of 36% and 21-day mortality of 53%, and John et al [ 17 ] reported a mortality rate of 49%). However, Sirohiya et al [ 11 ] reported a mortality rate of 12.28%. The difference in mortality rates reported in the literature may be due to their different demographic profiles, comorbidities, immunocompromised state, some forms of mucormycosis (especially pulmonary and cerebral), severity of COVID-19, treatment received, the time of surgery, and overall care of ROCM in different institutes.…”

Section: Discussionmentioning

confidence: 99%

“…The mean mortality time in the published literature ranges from 7 to 60 days [ 10 , 11 , 30 ]. In our study, the mean duration of hospital stay in a mortality group was 19.55 (12.64) days as compared to 26.94 (16.29) days in the non-mortality group, which is statistically significant (p=0.020), concluding that the severity of disease was more in the mortality group.…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Study to Evaluate the Perioperative Clinical Characteristics and Outcomes of Rhino-Orbital Cerebral Mucormycosis in COVID-19 Patients at a Tertiary Care Hospital in India

Talawar¹,

Tripaty²,

Singla³

et al. 2023

Cureus

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Background and aims A descriptive analysis of patients who underwent surgical debridement for coronavirus disease 2019 (COVID-19) related mucormycosis was described, which aimed at the evaluation of perioperative clinical characteristics, perioperative complications, and outcomes. Methods We conducted a retrospective study on patients who underwent surgical intervention for mucormycosis during the COVID-19 pandemic at a tertiary care institute in India from March 1, 2021, to June 30, 2021. The medical records of 92 patients were reviewed and analyzed. Results There was a male predominance with a mean age of 50.86 years. The most common comorbidity was diabetes mellitus (DM) (98.9%). Intra-operative complications included hypotension, hyperglycemia, and hypokalemia. Most of the patients (88%) were extubated inside the operation theater, and 48% of patients had mortality. Serum ferritin levels, computed tomography severity score (CTSS), and D-dimers were significantly high in the patient who had mortality. Conclusion The perioperative mortality in patients with COVID-19 associated mucormycosis was very high. DM was the most common comorbidity followed by hypertension. Pre-operative elevated serum ferritin, D-dimer, and high CTSS were associated with higher mortality; hypokalemia, followed by hypocalcemia, was the most common perioperative and post-operative electrolyte imbalance. Thorough pre-operative optimization, multidisciplinary involvement, and perioperative care are of the utmost importance to decrease mortality and improve outcomes.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Retrospective Study to Evaluate the Perioperative Clinical Characteristics and Outcomes of Rhino-Orbital Cerebral Mucormycosis in COVID-19 Patients at a Tertiary Care Hospital in India

Talawar¹,

Tripaty²,

Singla³

et al. 2023

Cureus

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“…Managing the airway of patients with mucormycosis can pose challenges. Fungal involvement in the oropharyngeal area and supraglottic edema can impede mask ventilation and endotracheal intubation (12). Facial edema and perioral wounds can compromise proper mask ventilation.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management of Mucormycosis Cases Requiring Surgical Debridement

Tuncer,

Akcaalan,

Kocagil

et al. 2024

JARSS

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Objective: Mucormycosis is a rare, progressive, and life-threatening fungal infection that occurs in immunocompromised patients. In the present study, we aimed to evaluate the perioperative challenges in the anesthetic management of mucormycosis patients. Methods: Patients over 18 years of age who underwent surgery for mucormycosis within a 3-year period between January 1, 2020 and December 31, 2022 were included in the study. Perioperative records were retrospectively evaluated. Results: During this period, 25 of 47 cases of mucormycosis were surgically treated. Data from these 25 cases were analyzed. Twelve (48%) patients had a diagnosis of rhinocerebral, 7 (28%) rhino-orbital, 5 (20%) rhino-orbito-cerebral and 1 (4%) rhino-pulmonary mucormycosis. All patients had comorbidities. The most common comorbidities were diabetes mellitus in 20 (80%), followed by hypertension in 12 (48%), acute kidney injury in 7 (28%) and coronary artery disease in 5 (20%) patients. Six (24%) patients had a history of COVID-19 infection and were treated with steroids. Intubation was difficult in 2 (8%) patients. Two (8%) patients had intraoperative hemodynamic instability requiring inotropes. There were 17 (68%) patients, 6 (24%) of whom were intubated, who were transferred to the intensive care unit (ICU). The median length of stay in the ICU was 22.7 days and the total length of stay was 42 days. Eleven (44%) patients required mechanical ventilation. Mortality occurred in 12 (48%) patients. Conclusion: Anesthetic management of surgical debridement for mucormycosis is challenging. Challenges include difficult intubation and renal dysfunction. Postoperative follow-up in the ICU is important due to rapid progression and comorbidities. Keywords: Mucormycosis, COVID-19, anesthesia

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“…Individuals with immunocompromised states have a tendency to develop Mucormycosis as the fungus enters their body from the infected hospital equipment such as nasopharyngeal tubings in the hospitals. 2 Consequently, most of the infections begin in the nasomaxillary region in which the earliest signs of the infection can be detected. The predisposing factors for the development of the dreadful fungal infection include diabetes mellitus with or without keto-acidosis, hematological or other malignancies, transplantation, iron overload, corticosteroid use, trauma, prolonged neutropenia, and malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Prosthetic rehabilitation of a patient with COVID-associated mucormycosis

Wani,

Tembhurne,

Gangurde

et al. 2023

JSAS

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Mucormycosis is a deep invasive mycotic infection caused by a group of molds referred to as mucormycetes. The incidence of mucormycosis increased markedly in the wake of the COVID-19 pandemic. The disease can be fatal in a very high percentage of individuals and in others, its effects can drastically affect the quality of life. The prognosis depends on the early diagnosis and treatment in which dental professionals play a major role, particularly in cases of rhinomaxillary mucormycosis. The present report describes the prosthetic management of a case of rhinomaxillary mucormycosis for functional restoration.

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Airway management, procedural data, and in-hospital mortality records of patients undergoing surgery for mucormycosis associated with coronavirus disease (COVID-19)

Cited by 4 publications

References 25 publications

A Retrospective Study to Evaluate the Perioperative Clinical Characteristics and Outcomes of Rhino-Orbital Cerebral Mucormycosis in COVID-19 Patients at a Tertiary Care Hospital in India

A Retrospective Study to Evaluate the Perioperative Clinical Characteristics and Outcomes of Rhino-Orbital Cerebral Mucormycosis in COVID-19 Patients at a Tertiary Care Hospital in India

Anesthetic Management of Mucormycosis Cases Requiring Surgical Debridement

Prosthetic rehabilitation of a patient with COVID-associated mucormycosis

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