Ophthalmic presentation and outcomes of rhino-orbito-cerebral mucormycosis during the COVID-19 pandemic: An 18-month follow-up report

PURPOSE

To investigate the long-term outcomes of COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM) patients.

METHODS

Retrospective, observational study including all COVID-19 patients who developed ROCM and were referred to our oculoplastic clinic.

RESULTS

Twenty-one patients with COVID-19-associated ROCM were included in this study. Twelve (57.1%) individuals were female with a mean age of 50.7±7.6 years (range 33-59), and nine (38.1%) were male with a mean age of 58.7±14.4 years (range 37-82). Corticosteroids were used in 85.7% of patients, and three patients received no systemic corticosteroids; 76.2% were diabetic and two of these developed new-onset diabetes mellitus (DM) after receiving corticosteroids during their treatment course. The average interval between COVID-19 and the development of ROCM in our subjects was 18.6 days (range 8-46 days). In our series of patients, decreasing vision, proptosis, and periorbital edema constituted the most prevalent presentation, seen in 52.4% of subjects. Endoscopic paranasal sinus debridement was performed a mean of 3.4 times in 95.2%, abscess drainage in one, and orbital exenteration in three (14.2%) patients. Orbital apex and bilateral paranasal sinus involvement were significantly associated with higher mortality, and the overall 18-month survival rate was 52.3%.

CONCLUSION

Based upon common factors among the COVID-19-associated ROCM patients, we presume that DM and drug-induced immunosuppression are two main factors, which may lead to a higher rate of ROCM infection in areas where fungal spores are more likely to be present, such as hospitals.

Adults' estimated prevalence of healthy behavior in society and self-reported oral health status and behaviors

OBJECTIVE

To assess Mashhad residents' self-perceived oral health level (OHL) and behaviors in relation to their perceptions of those of their fellow citizens.

METHODS

Cross-sectional telephone survey of 384 individuals recruited from communication centers. The interviews followed a validated Persian schedule with three main sections: 1) background information, 2) questions regarding self-reported OHL, and 3) questions regarding respondents' perceptions of the OHL of their fellow citizens.

RESULTS

Participants' mean self-rated OHL and tooth brushing frequency were higher than those of their fellow citizens. The correlation between self-reported and the estimated decayed and missing (DMT) was highest in the middle and lowest in the upper classes. Perceptions of the self- and others' OHL and DMT were positively correlated, with the latter being more so. Education level, age, and tooth brushing frequency affected self-perceived OHL and DMT.

CONCLUSION

Participants' perceived OHL could be explained by their estimation of the general population's oral health. These findings suggest that social norm interventions could nudge improving oral health behaviors.