Mucormycosis: A killer in the shadow of COVID-19

Suvvari, Tarun Kumar; Arigapudi, Nithya; Ramana, K V; Kutikuppala, LV Simhachalam

doi:10.1016/j.mycmed.2021.101161

Cited by 10 publications

(12 citation statements)

References 4 publications

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“…Prior to the COVID-19 pandemic, the mucormycosis mortality was 50%. However, during the current pandemic situation in India, it has increased to 85%, mainly due to crowded hospitals, unavailability of healthcare resources, overburdened healthcare workers, and poor diagnostic quality [ 18 ]. Notably, a recent systematic review of 7 global CAM cases observed 100% mortality, though 43% of them received antifungal monotherapy [ 19 ].…”

Section: The Surge In Covid-19–associated Mucormycosismentioning

confidence: 99%

“…The most common CAROCM symptoms observed in that study included orbital/facial pain (23%) and oedema (21%), vision loss (19%), ptosis (11%), and nasal congestion (9%); the primary signs included periocular/facial oedema (33%), vision loss (21%), proptosis (11%), and nasal discharge (10%) [ 34 ]. Pulmonary mucormycosis mimics the symptoms of COVID-19, such as pyrexia, cough, and dyspnea [ 18 ].…”

Section: Causes Characteristics and Diagnosismentioning

confidence: 99%

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COVID-19–associated mucormycosis: Evidence-based critical review of an emerging infection burden during the pandemic’s second wave in India

et al. 2021

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Coronavirus Disease 2019 (COVID-19), during the second wave in early 2021, has caused devastating chaos in India. As daily infection rates rise alarmingly, the number of severe cases has increased dramatically. The country has encountered health infrastructure inadequacy and excessive demand for hospital beds, drugs, vaccines, and oxygen. Adding more burden to such a challenging situation, mucormycosis, an invasive fungal infection, has seen a sudden surge in patients with COVID-19. The rhino-orbital-cerebral form is the most common type observed. In particular, approximately three-fourths of them had diabetes as predisposing comorbidity and received corticosteroids to treat COVID-19. Possible mechanisms may involve immune and inflammatory processes. Diabetes, when coupled with COVID-19–induced systemic immune change, tends to cause decreased immunity and an increased risk of secondary infections. Since comprehensive data on this fatal opportunistic infection are evolving against the backdrop of a major pandemic, prevention strategies primarily involve managing comorbid conditions in high-risk groups. The recommended treatment strategies primarily included surgical debridement and antifungal therapy using Amphotericin B and selected azoles. Several India-centric clinical guidelines have emerged to rightly diagnose the infection, characterise the clinical presentation, understand the pathogenesis involved, and track the disease course. Code Mucor is the most comprehensive one, which proposes a simple but reliable staging system for the rhino-orbital-cerebral form. A staging system has recently been proposed, and a dedicated registry has been started. In this critical review, we extensively analyse recent evidence and guidance on COVID-19–associated mucormycosis in India.

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Section: The Surge In Covid-19–associated Mucormycosismentioning

confidence: 99%

Section: Causes Characteristics and Diagnosismentioning

confidence: 99%

COVID-19–associated mucormycosis: Evidence-based critical review of an emerging infection burden during the pandemic’s second wave in India

et al. 2021

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“…[137] Such infections spread due to the rampant misuse or overuse of steroids, monoclonal antibodies, and broad-spectrum antibiotics during COVID-19 treatment [47]. As India has second largest diabetic population with around 70% are uncontrolled cases, such coinfection has become more common here [135]. Hence, higher mortality rate (~87%) is observed these days as compared to earlier reports (~50%) during non-COVID times [48,138].…”

Section: Mucormycosismentioning

confidence: 98%

“…Mucormycosis, also known as black fungus or zygomycosis, is found in the environment and is caused by a group of molds called mucormycetes that mainly affect the sinuses or the lungs of people with reduced immunity [135]. It is a rare albeit deadly fungal infection and is now detected in COVID-19 patients in India too.…”

Section: Mucormycosismentioning

confidence: 99%

“…The symptoms are pain and redness around the eyes or nose, blurred or double vision, loosening of teeth, toothache, blackish/bloody discharge from nose, bloody vomits, swelling in cheekbones, skin lesion, chest pain, fever, headache, dyspnea, coughing, and may also alter mental status [135,136]. This infection is observed in the convalescing COVID-19 patients having issues related to diabetes, prolonged ICU stay, prolonged medical oxygen use, high blood sugars, chronic kidney disease, HIV/AIDS, hematological malignancies, solid organ transplant, etc.…”

Section: Mucormycosismentioning

confidence: 99%

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The microbiota-related coinfections in COVID-19 patients: a real challenge

Mohapatra¹,

Dhama

Mishra

et al. 2021

Beni-Suef Univ J Basic Appl Sci

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Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of ongoing global pandemic of coronavirus disease 2019 (COVID-19), has infected millions of people around the world, especially the elderly and immunocompromised individuals. The infection transmission rate is considered more rapid than other deadly pandemics and severe epidemics encountered earlier, such as Ebola, Zika, Influenza, Marburg, SARS, and MERS. The public health situation therefore is really at a challenging crossroads. Main body The internal and external and resident microbiota community is crucial in human health and is essential for immune responses. This community tends to be altered due to pathogenic infections which would lead to severity of the disease as it progresses. Few of these resident microflora become negatively active during infectious diseases leading to coinfection, especially the opportunistic pathogens. Once such a condition sets in, it is difficult to diagnose, treat, and manage COVID-19 in a patient. Conclusion This review highlights the various reported possible coinfections that arise in COVID-19 patients vis-à-vis other serious pathological conditions. The local immunity in lungs, nasal passages, oral cavity, and salivary glands are involved with different aspects of COVID-19 transmission and pathology. Also, the role of adaptive immune system is discussed at the site of infection to control the infection along with the proinflammatory cytokine therapy.

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