{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:14:12Z","timestamp":1792084452233,"version":"4.4.0"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The second COVID\u201019 wave in India has been associated with an unprecedented increase in cases of COVID\u201019 associated mucormycosis (CAM), mainly Rhino\u2010orbito\u2010cerebral mucormycosis (ROCM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted at Noble hospital and Research Centre (NHRC), Pune, India, between 1 April, 2020, and 1 August, 2021, to identify CAM patients and assess their management outcomes. The primary endpoint was incidence of all\u2010cause mortality due to CAM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      59 patients were diagnosed with CAM. Median duration from the first positive COVID\u201019 RT PCR test to diagnosis of CAM was 17 (IQR: 12,22) days. 90% patients were diabetic with 89% having uncontrolled sugar level (HbA1c &gt;7%). All patients were prescribed steroids during treatment for COVID\u201019. 56% patients were prescribed steroids for non\u2010hypoxemic, mild COVID\u201019 (irrational steroid therapy), while in 9%, steroids were prescribed in inappropriately high dose. Patients were treated with a combination of surgical debridement (94%), intravenous liposomal Amphotericin B (91%) and concomitant oral Posaconazole (95.4%). 74.6% patients were discharged after clinical and radiologic recovery while 25.4% died. On relative risk analysis, COVID\u201019 CT severity index \u226518 (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.017), presence of orbital symptoms (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.002), presence of diabetic ketoacidosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.011) and cerebral involvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0004) were associated with increased risk of death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CAM is a rapidly progressive, angio\u2010invasive, opportunistic fungal infection, which is fatal if left untreated. Combination of surgical debridement and antifungal therapy leads to clinical and radiologic improvement in majority of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.13435","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T03:30:34Z","timestamp":1645759834000},"page":"526-540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Epidemiology, clinical presentation and management of COVID\u201019 associated mucormycosis: A single centre experience from Pune, Western India"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1909-7530","authenticated-orcid":false,"given":"Ameet","family":"Dravid","sequence":"first","affiliation":[{"name":"Department of Infectious diseases and HIV\/AIDS Noble hospitals and Research Centre  Pune MH 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