Clinical outcome and toxicity in post-COVID suspected cases of mucormycosis treated with amphotericin B at dedicated COVID hospital: a prospective observational study

Abstract

Background: Recently, several cases of mucormycosis in people with COVID-19 have been increasingly reported world-wide, in particular from India. Lipid formulations of amphotericin B are often used as first-line treatment. Present study aims to assess and analyze clinical outcome and toxicity in post-COVID suspected cases of mucormycosis treated with amphotericin B at dedicated COVID hospital.Methods: The present study was a prospective observational study conducted at government medical college, Jalgaon which was a dedicated COVID hospital. Clinically suspected cases of mucormycosis treated with Amphotericin B were included in the study. We collected the data of previous treatment records, demographics, comorbidities, laboratory investigations and clinical outcome from the case files of patients admitted with diagnosis of clinically suspected mucormycosis with history of COVID-19 infection.Results: Out of 57 patients, majority of them belonged to age group of 51-60 years comprising of 21 patients (37%) and 86% had involvement of one or more paranasal sinus/es. On analyzing prescription pattern and outcomes in patients of present study, it was found that majority of the patients had recovered completely comprising of 40 patients (70%), of which 21 patients (37%) had received liposomal amphotericin B, followed by lipid emulsion amphotericin B in 12 patients (21%).Conclusions: The present study was first of its kind to analyze the prescribing trend of amphotericin B and outcomes in clinically suspected post-COVID cases of mucormycosis. Liposomal amphotericin B was found to be more effective and safer in terms of better recovery rate and less adverse events.