Retracted: Mucormycosis infection in patients with COVID‐19: A systematic review

Abstract

Introduction Several reports previously described mucormycosis co‐infection in patients with COVID‐19. As mucormycosis and COVID‐19 co‐infection might adversely affect patients' outcomes, we aimed to systematically review the related evidence and the subsequent outcomes. Methods We conducted a systematic review of relevant articles searching the keywords in the online databases of PubMed, Scopus, Embase, Cochrane, and Web of Science. All the records from the start of the pandemic until June 12th, 2021 underwent title/abstract and then full‐text screening process, and the eligible studies were included. We did not include any language or time restrictions for the included studies. Results We found 31 eligible studies reporting 144 total cases of COVID‐19 and mucormycosis co‐infection. The nose, cranial sinuses, and orbital cavity were the most commonly involved organs, although the cerebrum, lungs, and heart were also involved in the studies. Pre‐existing diabetes mellitus (DM), as well as corticosteroid use, were the most commonly identified risk factors, but other underlying conditions and immunomodulatory drug use were also present in several cases. Aspergillus was the most commonly reported micro‐organism that caused further co‐infections in patients with concurrent COVID‐19 and mucormycosis. As most of the studies were case reports, no reliable estimate of the mortality rate could be made, but overall, 33.6% of the studied cases died. Conclusion Early diagnosis of mucormycosis co‐infection in COVID‐19 patients and selecting the right treatment plan could be a challenge for physicians. Patients with underlying co‐morbidities, immunocompromised patients, and those receiving corticosteroids are at higher risk of developing mucormycosis co‐infection and it is crucial to have an eye examination for early signs and symptoms suggesting a fungal infection in these patients.

Retrobulbar Injection of Amphotericin B in Patients With COVID-19 Associated Orbital Mucormycosis: A Systematic Review

“…The overall mortality rate among CAM patients was 11.8%, which is lower than previous reviews (25.6–33.6%). 1 , 37 , 39 – 42 The lower rate of mortality in our study can be explained by the lower percentage of patients with intracranial involvement compared with the previous reviews and, therefore, as the mortality rate of mucormycosis is known to be highly dependent on the involved site, meaning that a disseminated infection is the most fatal. 43 …”

“…1,[40][41][42] The overall mortality rate among CAM patients was 11.8%, which is lower than previous reviews (25.6-33.6%). 1,37,[39][40][41][42] The lower rate of mortality in our study can be explained by the lower percentage of patients with intracranial involvement compared with the previous reviews and, therefore, as the mortality rate of mucormycosis is known to be highly dependent on the involved site, meaning that a disseminated infection is the most fatal. 43 In a study by Bhattacharyya et al 39 the most commonly reviewed ophthalmic signs of the disease were ptosis, eyelid edema, proptosis, ophthalmoplegia, and vision loss, respectively.…”

Biofilms possibly harbor occult SARS-CoV-2 may explain lung cavity, re-positive and long-term positive results

“…Characteristics of cases that SARS-CoV-2 co-infects with other pathogens include venerable age, glucocorticoid therapy, immunocompromised state, long-term antibiotic use history, diabetes, cardiovascular comorbidities, intensive care unit attending, ventilation treatment, prolonged hospitalization time, and exacerbation of symptoms ( Bao et al., 2020 ; Blasco et al., 2020 ; Contou et al., 2020 ; Wang et al., 2020a ; Alhumaid et al., 2021 ; He et al., 2021 ; Yasmin et al., 2021 ; Gomes et al., 2022 ; Hedberg et al., 2022 ; Ortega-Pena et al., 2022 ; Rouze et al., 2022 ; SeyedAlinaghi et al., 2022 ; Shetty et al., 2022 ). Bacterial pathogens generally isolated cover M. pneumoniae , P. aeruginosa , H. influenzae , K. pneumoniae and S. pneumoniae ( Lansbury et al., 2020 ).…”

“…Abundant cases of SARS-CoV-2 co-infection with other microorganisms have been reported, which were associated with venerable age, immunosuppression, cardiovascular disease, diabetes, intensive care unit attending, mechanical ventilation treatment, long-term antibiotic use, glucocorticoid therapy, prolonged hospitalization, exacerbation of symptoms, and poor prognosis ( Bao et al., 2020 ; Blasco et al., 2020 ; Contou et al., 2020 ; Wang et al., 2020a ; Alhumaid et al., 2021 ; He et al., 2021 ; Yasmin et al., 2021 ; Gomes et al., 2022 ; Hedberg et al., 2022 ; Ortega-Pena et al., 2022 ; Rouze et al., 2022 ; SeyedAlinaghi et al., 2022 ; Shetty et al., 2022 ). M. pneumoniae , P. aeruginosa , H. influenzae , and K. pneumoniae are bacterial co-pathogens usually detected ( Lansbury et al., 2020 ).…”

“…The presence of biofilms in the sinuses of experimental animals infected with Pseudomonas aeruginosa was identified by scanning electron microscopy ( Vlastarakos et al., 2007 ). A systematic review of COVID-19 and Mucor co-infection shows that the most common co-infection spots are the nasal cavity, sinuses, and orbit, and can further co-infect with Aspergillus ( SeyedAlinaghi et al., 2022 ). In this review, 45 (33.6%) out of 134 co-infected patients died, and related co-infection risk factors include diabetes, glucocorticoids therapy, immunomodulatory drugs use, immunocompromised status, hypertension, hematological malignancies, etc.…”