Correlation of the severity of mucormycosis with levels of inflammatory markers in COVID-19 patients

Abstract

Purpose: The purpose of the study is to explore the clinical spectrum of rhino‑orbital cerebral mucormycosis (ROCM) and to correlate its severity with the levels of inflammatory markers of COVID‑19 patients. Materials and Methods: It is an observational analytical study. Clinical and laboratory data of the patients with mucormycosis admitted in COVID‑19 wards in a notified nodal tertiary care center were collected and stratified clinically according to the severity of ROCM. Serum ferritin, serum lactate dehydrogenase (LDH), D‑dimer, total count, neutrophils, and lymphocyte count were considered primary outcome variables. The severity of the ROCM (Stage II, Stage III, and Stage IV mucormycosis) was considered the primary explanatory variable. Results: Forty‑five participants were included, of which 38 (84%) were male and 7 (16%) were female. The mean age was 48.71 ± 10.71 years, which ranged from 29 to 75 years. In people with the severity of the ROCM, 26 (58%) were in Stage II, 15 (33%) were in Stage III, and 4 (9%) were in Stage IV. The mean serum ferritin, mean serum LDH, and D‑dimer across the severity of ROCM were statistically significant. The median total count, mean neutrophils, and mean lymphocytes across the severity of ROCM were not statistically significant. Conclusion: The study shows that raised serum ferritin, LDH, and D‑dimer levels at admission significantly predict disease severity in COVID‑19 patients with mucormycosis. Mucormycosis and its severity are associated with higher inflammatory markers levels than the mild disease in COVID‑19 patients. Tracking these markers may allow early identification or even prediction of disease progression.