srjcmsSRJCMSSRJCMS2788-8851https://doi.org/10.47310/srjcms.2023.v03i01.015Covid-Associated Mucormycosis at Tertiary Care InstituteVibhaThakurSwatiSharmaVinodMehtaVineetaSharmaGarimasharmaSantwanaVermaPG student, Department of Microbiology, IGMC, Shimla, HP, IndiaAssistant professors, Department of Microbiology, IGMC, Shimla, HP, IndiaAssociate professor, Department of Microbiology, IGMC, Shimla, HP, IndiaProfessor and Head, Department of Microbiology, IGMC, Shimla, HP, IndiaBackground: Mucormycosis is an angio-invasive infection, caused by ubiquitous environmental fungal species of the order Mucorales including Rhizopus, Lichtheimia, Mucor, and Rhizomucor species. The clinical presentation of mucormycosis varies according to the anatomical site of involvement. The incidence rate of mucormycosis globally varies from 0.005 to 1.7 per million population. India’s yearly prevalence of CAM is around 0.02-9.5 cases per 100,000 people. COVID -19 associated mucormycosis was mostly isolated during the second wave with mortality of 31-50%. Objective: To identify the outcome of early diagnosis and initiation of antifungal treatment in CAM-associated mortality and morbidity. Material& Methods: A study was done at IGMC Shimla over a period of 8 months (May 2021 to December 2022). All hospitalized patients diagnosed with COVID-19 and with suspected mucormycosis were included in the study. Biopsy/scrapings of affected area were collected and received at Microbiology department. Samples were subjected to direct microscopy using 10%/20% KOH for fungal elements and cultured on Sabouraud’s dextrose agar with chloramphenicol and cycloheximide at 25o and 370C. The fungal diagnosis was done by LCB mount. Results: A total of 913 cases of covid-19 were admitted in the isolation unit during this period out of which 62(6.8%) were suspected of mucormycosis. Samples were sent for processing. KOH positive in 14% and 18% were culture positive. Rhizopus (84%) and Lichtheimia (7%) species were found. Patients affected were mainly in the 5th (15%) and 6th (38%) decade of life. Results identified diabetes (76%) as the primary predisposing factor. Other comorbidities like hypertension (15%) and hepatitis C virus (15%) were also found in CAM cases. Rhino-orbital-cerebral infection was most common with involvement of nasal mucosa (69%), palate (15%), brain (7%) and orbit (15%). Initiation of antifungal therapy improved outcome in CAM. Overall mortality observed in COVID-associated mucormycosis was 32%. Conclusion: CAM could be avoided by early diagnosis, identifying high-risk groups and managing uncontrolled diabetes. All these factors would help the clinicians to decrease mortality and morbidity in CAM.