Psychological impact of surgical management in COVID-associated mucormycosis patients: Scenario in eastern India
Pradipta Kumar Parida, Abhijeet Kumar Mishra, Mathan Kumar Ramasubbu, Vinusree KarakkandyObjectives
The objective of this study was to analyze the relation of patient health questionnaire (PHQ-9) scores with the extent of COVID-associated mucormycosis (CAM), the surgical approach used for treatment, the extent of surgery (structures removed), and to report the epidemiology of CAM in Eastern India, where the incidence of mucormycosis is rare.
Material and Methods
This is a cohort study done from May 2021 to July 2021, which was performed at a tertiary care institute in Eastern India. Forty patients of CAM who received surgical and pharmacological therapy were included. The PHQ-9 was administered after 6 weeks of the initiation of treatment.
Results
Statistical analysis regarding the demographics and relation of PHQ-9 scores with the extent of disease, surgical approach, and extent of surgery was performed. The mean age of presentation was 49 years, with a male-to-female ratio of 7:1. The most common presenting complaint was hemifacial pain. The most commonly involved sinus was maxillary sinus. There was no significant impact of intracranial and intraorbital extension of disease on the PHQ-9 scores. However, palatal removal had a significant impact on the PHQ-9 scores ( p = 0.03).
Conclusion
Hard palate should be preserved or reconstructed wherever possible. Orbital exenteration did not affect the scores significantly; hence, it should be performed wherever indicated to ensure better chances of survival for the patient. Other, more specific measures pertaining to CAM are required for determining the psychosocial impact of surgical management in CAM patients more accurately.