{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T05:25:23Z","timestamp":1774675523365,"version":"3.50.1"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0\u00b720 were considered for the regression model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45\u201359 years (2\u00b71; 1\u00b74 to 3\u00b71), having diabetes mellitus (4\u00b79; 3\u00b74 to 7\u00b71), elevated plasma glucose (6\u00b74; 2\u00b74 to 17\u00b72), steroid use (3\u00b72; 2 to 5\u00b72) and frequent nasal washing (4\u00b78; 1\u00b74 to 17). Among those never hospitalised, age \u2265 60 years (6\u00b76; 3\u00b73 to 13\u00b73), having diabetes mellitus (6\u00b77; 3\u00b78 to 11\u00b76), elevated plasma glucose (13\u00b77; 2\u00b72 to 84), steroid use (9\u00b78; 5\u00b78 to 16\u00b76), and cloth facemask use (2\u00b76; 1\u00b75 to 4\u00b75) were associated with increased risk of post-COVID ROCM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0272042","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T17:23:57Z","timestamp":1659979437000},"page":"e0272042","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":24,"title":["Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India"],"prefix":"10.1371","volume":"17","author":[{"given":"Manickam","family":"Ponnaiah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivaraman","family":"Ganesan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarun","family":"Bhatnagar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-2855","authenticated-orcid":true,"given":"Mahalakshmy","family":"Thulasingam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Gilbert","family":"Majella","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7766-4978","authenticated-orcid":true,"given":"Mathan","family":"Karuppiah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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