Health-related quality of life after orbital exenteration for COVID-19–associated rhino-orbital-cerebral mucormycosis in South India: a cross-sectional SF-36 study and systematic review

PURPOSE: Rhino-orbital-cerebral mucormycosis (ROCM) surged during the COVID-19 pandemic, often necessitating orbital exenteration for disease control. While survival outcomes are increasingly reported, long-term health-related quality of life (HRQoL) among survivors remains poorly characterized, particularly in low- and middle-income settings. This study evaluated HRQoL using the SF-36 among survivors of COVID-19-associated ROCM who underwent orbital exenteration. METHODS: In this cross-sectional study, adult survivors of orbital exenteration for COVID-19-associated ROCM treated at a tertiary center in South India completed the SF-36 questionnaire. SF-36 domain and component scores were compared with Indian normative values using Welch's t-tests. Multivariable linear regression assessed associations between demographic and clinical factors and Physical (PCS) and Mental (MCS) Component Summary scores. A parallel narrative review of QoL studies in COVID-19-associated mucormycosis was conducted. RESULTS: < 0.001). Social Functioning showed the greatest deficit (-38.28 points vs norms). Male sex was associated with higher PCS, and receipt of any COVID-19 vaccination was associated with higher MCS. CONCLUSIONS: Survivors of orbital exenteration for COVID-19-associated ROCM exhibit preserved physical health but substantial impairments in mental health and social functioning, highlighting the need for integrated psychosocial care and accessible rehabilitation in post-ROCM survivorship.