Evidence map›Paper›PMID 36645635›Full record

ArticleInternational ophthalmology2023

Mortality and its determinants after an outbreak of post COVID-19 associated rhino-orbito-cerebral mucormycosis in Central India.

Nitin M Nagarkar, Vijaya Sahu, Ripudaman Arora, Madhumallika Pathak, Martina S Shambharkar, Prithvi Naveen

Open access · bronzeAbstract read
In one paragraph

Article in International ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Outcomes of COVID-19-associated mucormycosis epidemic in India: A prospective 2-year follow-up study.World journal of otorhinolaryngology - head and neck surgery · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Nitin M NagarkarDepartment of ENT, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Vijaya SahuDepartment of ENT, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India. drvijayasahu77@gmail.com.
Ripudaman AroraDepartment of ENT, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Madhumallika PathakDepartment of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Martina S ShambharkarDepartment of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Prithvi NaveenDepartment of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
All India Institute of Medical Sciences Raipur · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo report cumulative mortality rates using survival analysis from an outbreak of 211 patients with post COVID-19 rhino-orbito-cerebral mucormycosis (ROCM) in central India.

methodsCase files of eligible patients were evaluated and mucor was identified from deep nasal swabs using freshly prepared KOH mount. All patients underwent contrast enhanced MRI and disease staging was done based on the extent of anatomical involvement. All patients received intravenous Amphotericin B and sinus debridement was done when possible. Orbital exenteration was reserved for patients with advanced orbital disease.

resultsThe mean age was 50.7 ± 10.2 of which 147 (70%) were men. At presentation, ROCM was limited to sinuses in 72 (34%), orbital extension was seen in 102 (48%) and 31 (15%) had CNS extension. Sinus debridement was possible in 82% cases (n = 173). Thirty-five (16.6%) patients died due to ROCM. The mean follow-up of patients who survived was 126.6 ± 16.4 days. The cumulative mortality rate at day 10 was 4.8% (95%CI = 2.6-8.8%) and increased 13.1% (95%CI = 9.1-18.7%) at day 30 and to 18.4% (95%CI = 13.6-24.8%) at day 60. Majority of deaths (n = 26, 75%) occurred within 1-month of ROCM presentation. Multivariable hazards analysis showed that patients with CNS involvement had a 6.5 times higher risk of death (Hazard Ratio = 6.71, 95% CI = 2.9-15.5, p < 0.001).

conclusionWe report significantly lower mortality rates compared to recent literature that varies from 30 to 80% at 1-month follow-up. Timely sinus debridement and systemic Amphotericin B can help reduce mortality. Presence of CNS extension significantly increased the mortality risk with patients with ROCM.

Indexed as

COVID-19MucormycosisOrbital DiseasesAdultAmphotericin BAntifungal AgentsDisease OutbreaksFemaleHumansMaleMiddle AgedAmphotericin BAntifungal AgentsCOVID-19Rhino-orbito-cerebral mucormycosisSinus debridementTotal ophthalmoplegia

Identifiers

PMID36645635
PMCPMC9841924
OpenAlexW4316507336

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.