COVID-19-Associated Mucormycosis: An Opportunistic Fungal Infection. A Case Series and Review

Balushi, Asma Al; Ajmi, Ahmed Al; Sinani, Qais Al; Menon, Varna; Berieki, Zainab Al; Shezawi, Asma Al; Azri, Saleh Al; Al-Rashdi, Azza; Jardani, Amina Al; Baluki, Thuwaiba Al; Ghaithi, Salem Al; Reesi, Ali Al; Al-Zaabi, Ahmed Talib; Balushi, Mohammed Abdullah Al’; Maqbali, Talib Al

doi:10.1016/j.ijid.2022.05.005

Cited by 28 publications

(27 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior to COVID-19, there were very few articles published in various journals about the histopathological features of mucormycosis. During the second wave of COVID-19, the most common virulent strain of COVID was the Delta variant (B.1.617.2), which was associated with a post-COVID complication "black fungus", a colloquial term for mucormycosis, an aggressive and opportunistic fungal infection [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Preliminary Experience in Post-COVID-19 Mycoses: A Pathologist’s Perspective

Walke¹,

Jayashankar²,

Khurana³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Preliminary Experience in Post-COVID-19 Mycoses: A Pathologist’s Perspective

Walke¹,

Jayashankar²,

Khurana³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…A total of 8727 cases of CAM are reported in the 88 qualified studies ( Table 1 ), the majority of them from India (n = 8388, 96.1%), 208 patients (2.4%) were from Egypt and 40 patients (0.46%) from Europe (France and Germany) ( Figure 2 ). CAM cases have also been reported in USA [ 41 ], Pakistan [ 70 ], Iran [ 84 ], Oman [ 113 ], Syria [ 115 ], Iraq [ 116 ], Latin America [ 117 ] and Turkey [ 7 ].…”

Section: Incidence Of Cammentioning

confidence: 99%

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

et al. 2022

View full text Add to dashboard Cite

A mucormycosis surge was reported during the COVID-19 pandemic in India. A literature search until 14 July 2022, with the aim of updating COVID-19-associated mucormycosis (CAM), identified 663 studies and 88 met inclusion criteria (8727 patients). India reported 8388 patients, Egypt 208 and Europe 40. Rhino-orbito-cerebral mucormycosis (ROCM) was identified among 8082 (98.3%) patients, followed by 98 (1.2%) with pulmonary. In India, 82.6% of patients had diabetes mellitus, with 82% receiving corticosteroids. In Europe, 75% presented pulmonary CAM, 32.5% had diabetes and 40% were immunocompromised. CAM was identified at a median of 17.4 days (IQR 7.5 days) post COVID-19 diagnosis, and PCR was performed in five studies. Rhino-orbital invasion is clinically obvious, while cerebral involvement presents with cavernous sinus thrombosis, meningitis and cerebrovascular disease. Symptoms of pulmonary CAM usually overlap with severe COVID-19 pneumonia. High-dose liposomal Amphotericin B (and early surgical debridement in ROCM) are the mainstay of therapy. The median mortality rate was estimated to be 21.4% (IQR 31.9%), increased by the presence of pulmonary (80% (IQR 50%) or cerebral involvement (50% (IQR 63.9%). In summary, different CAM clinical phenotypes need to be distinguished, influenced by geographical presentation. Opportunities exist for diagnosis and therapy optimization, based on earlier high-dose antifungal therapy, early source control, strict glycemic control and restriction of steroids to COVID-19 patients with oxygen requirements.

show abstract

“…Importantly, PAIS after COVID-19 is not only associated with the systemic, respiratory, and neurological symptoms, but also related to pathology in the oral and maxillofacial region. During the second wave of the COVID-19 pandemic, a sudden and rapid rise in rhino-orbital-cerebral mucormycosis incidence was observed and has been identified as a deadly complication of this viral infection 8 . Because of the sudden, rocket high incidence in a brief period, it was defined as CO-VID-19 associated mucormycosis (CAM) especially affecting maxilla and adjacent facial tissues [8][9][10] .…”

mentioning

confidence: 99%

“…During the second wave of the COVID-19 pandemic, a sudden and rapid rise in rhino-orbital-cerebral mucormycosis incidence was observed and has been identified as a deadly complication of this viral infection 8 . Because of the sudden, rocket high incidence in a brief period, it was defined as CO-VID-19 associated mucormycosis (CAM) especially affecting maxilla and adjacent facial tissues [8][9][10] . Before the outbreak of the COVID-19 pandemic, global prevalence of mucormycosis was as low as 0.005 to 1.7 per million population 11 ; however, the prevalence is 80 times higher than that recorded in developed countries after COVID-19 12 .…”

mentioning

confidence: 99%

“…Pathogenesis of CAM is currently understood as an opportunistic fungal infection where the immune cells in the SARS-CoV-2 infected host defense differently against commensal or invaded fungal colony 13 . Interestingly, other kinds of opportunistic infections have been reported in the oral and maxillofacial region as PAIS, such as worsened periodontitis, avascular necrosis of jaw, and various spectrum of oral mucositis [8][9][10][11][12][13][14][15][16][17][18][19] . (Table 1) One of the suggested mechanisms of those oral and maxillofacial manifestations is the direct vulnerability of the oral mucosa to SARS-CoV-2 infection.…”

mentioning

confidence: 99%

See 1 more Smart Citation