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Introduction The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in significant morbidity and mortality worldwide. While primarily a respiratory illness, COVID-19 can lead to multi-organ involvement, including acute kidney injury (AKI). This study aimed to retrospectively analyze the incidence, risk factors, and outcomes of AKI in COVID-19 patients. Methods A single-center retrospective study involving 232 severe COVID-19 patients requiring ICU admission was analyzed. Patients were categorized into two groups based on renal involvement: group A (with AKI or worsening of pre-existing chronic kidney disease) and group B (without renal injury). Data on demographics, comorbidities, clinical presentation, inflammatory markers, management strategies, and outcomes were collected and analyzed. Results AKI or worsening of pre-existing chronic renal disease was noted in 50.87% of cases, while the remaining 49.13% had severe COVID-19 pneumonia without renal injury. The mean age of patients in group A (with renal involvement) was higher compared to group B (without renal injury), with a significant male predominance observed in group A. AKI occurred within a short duration of fever, and cough was not a significant symptom. Comorbidities such as diabetes, hypertension, and chronic kidney disease were common in both groups, with hypertension significantly associated with AKI. Other significant comorbidities as risk factors for kidney injury included chronic liver disease, coronary artery disease, chronic kidney disease, and malignancy. Elevated inflammatory markers, including C-reactive protein (CRP), serum ferritin, and interleukin-6, were significantly associated with renal injury. There was no significant difference in the mortality rate between the two groups studied. Conclusion AKI or worsening of pre-existing kidney disease is a common event in severe COVID-19 infection. Patients, especially elderly males with comorbidities as mentioned, should be thoroughly monitored for worsening renal function, and steps like avoidance of nephrotoxic drugs and timely hemodynamic support may help avoid this dreaded complication to a certain extent and improve the prognosis in severe COVID-19 infection. Supportive care remains crucial in managing COVID-19 patients with renal involvement, emphasizing the need for the early detection and treatment of renal abnormalities. Long-term follow-up is essential to assess the impact of AKI on future kidney health.
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Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome. The hard palate had been eroded with formation of black eschar. Computed tomography of paranasal sinuses revealed right maxillary and ethmoid sinusitis, with spread of inflammation to infratemporal fossa and parapharynygeal neck spaces. Debridement of sinus mucosa was done, and culture of the same yielded growth of rhizopus species. Histopathological examination of the tissue showed angioinvasion and fungal hyphae suggestive of mucormycosis. She was treated with amphotericin B, posaconazole, and periodic nasal sinus debridement, but her general condition worsened after 8 weeks due to secondary sepsis and she succumbed to death.