Abstract
Background: The recent emergence of the Coronavirus Disease (COVID-19) disease had been associated with reports of fungal infections such as aspergillosis and mucormycosis especially among critically ill patients treated with steroids. The recent surge in cases of COVID-19 in India during the second wave of the pandemic had been associated with increased reporting of invasive mucormycosis post COVID-19. There are multiple case reports and case series describing mucormycosis in COVID-19.
Purpose: In this review, we included most recent reported case reports and case-series of mucormycosis among patients with COVID-19 and describe the clinical features and outcome.
Results: Many of the mucormycosis reports were eported from India, especially in COVID-19 patients who were treated and recovered patients. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis. Those patients were diabetic and had corticosteroids therapy for controlling the severity of COVID-19, leading to a higher fatality in such cases and complicating the pandemic scenario. The triad of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), corticosteroid use and uncontrolled diabetes mellitus have been evident for significant increase in the incidence of angioinvasive maxillofacial mucormycosis. In addition, the presence of spores and other factors might play a role as well.
Conclusion: With the ongoing COVID-19 pandemic and increasing number of critically ill patients infected with SARS-CoV-2, it is important to develop a risk-based approach for patients at risk of mucormycosis based on the epidemiological burden of mucormycosis, prevalence of diabetes mellitus, COVID-19 disease severity and use of immune modulating agents including the combined use of corticosteroids and immunosuppressive agents in patients with cancer and transplants.
Keywords: COVID-19; Mucormycosis; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Mucormycosis, 【초록키워드】 Corticosteroid, SARS-CoV-2, coronavirus, pandemic, COVID-19 pandemic, India, Infection, Diabetes Mellitus, risk, outcome, Steroids, immune, Case report, Prevalence, severity of COVID-19, Patient, second wave, epidemiological, incidence, recovered patients, disease, clinical feature, fatality, COVID-19 patient, Fungal infection, Critically ill patient, Patients with cancer, Diabetic, acute respiratory syndrome, Factor, significant increase, COVID-19 disease severity, spore, transplants, combined use, approach, invasive, corticosteroids therapy, develop, reported, addition, case sery, treated, immunosuppressive agent, infected with SARS-CoV-2, modulating, patients with COVID-19,