Abstract:The pandemic of coronavirus disease 2019 (COVID-19) still remains on an upsurge trend. The second wave of this disease has led to panic in many countries, including India and some parts of the world suffering from the third wave. As there are no proper treatment options or remedies available for this deadly infection, supportive care equipment's such as oxygen cylinders, ventilators and heavy use of steroids play a vital role in the management of COVID-19. In the midst of this pandemic, the COVID-19 patients a… Show more
“…The shift of managing mucormycosis should also be focused on prevention by understanding the associated risk factors. The risk factors associated with development of mucormycosis include the following: diabetes mellitus, broad spectrum antibiotics, neutropenia, elevated iron levels in circulatory blood, organ transplant, stem cell transplant, intravenous drug abuse, steroid usage, hematological malignancies, renal insufficiency, voriconazole usage, trauma, and burns [ 3 ]. Understanding the risk factors will pave the way for healthcare physicians on proper management strategy for COVID-19 infections for identifying vulnerable populations.…”
This letter is a response to commentary by Ambadasu et al. on a review article by Santosh et al. on âFungal Infections of Oral Cavity: Diagnosis, Management, and Association with COVID-19.â In their commentary, Ambadasu et al. mentioned that in the list of COVID-19 associated fungal infections, mucormycosis should be added. In this response, we provide our thoughts on including mucormycosis in COVID-19 associated fungal infections of the oral cavity. We conclude that mucormycosis surge was more prevalent during the second wave of COVID-19 infection. Majority of published reports on oral fungal infections during the years 2019 and 2020 was focused on Oral Candidiasis, whereas mucormycosis appears to be re-emerging opportunistic entry of fungal infection among COVID-19 infection due to associated risk factors. Thus, Physicians and Dentists must be cautioned that other listed opportunistic fungal infections of oral cavity may also be seen among severe COVID-19 patients.be seen among severe COVID-19 patients.
“…The shift of managing mucormycosis should also be focused on prevention by understanding the associated risk factors. The risk factors associated with development of mucormycosis include the following: diabetes mellitus, broad spectrum antibiotics, neutropenia, elevated iron levels in circulatory blood, organ transplant, stem cell transplant, intravenous drug abuse, steroid usage, hematological malignancies, renal insufficiency, voriconazole usage, trauma, and burns [ 3 ]. Understanding the risk factors will pave the way for healthcare physicians on proper management strategy for COVID-19 infections for identifying vulnerable populations.…”
This letter is a response to commentary by Ambadasu et al. on a review article by Santosh et al. on âFungal Infections of Oral Cavity: Diagnosis, Management, and Association with COVID-19.â In their commentary, Ambadasu et al. mentioned that in the list of COVID-19 associated fungal infections, mucormycosis should be added. In this response, we provide our thoughts on including mucormycosis in COVID-19 associated fungal infections of the oral cavity. We conclude that mucormycosis surge was more prevalent during the second wave of COVID-19 infection. Majority of published reports on oral fungal infections during the years 2019 and 2020 was focused on Oral Candidiasis, whereas mucormycosis appears to be re-emerging opportunistic entry of fungal infection among COVID-19 infection due to associated risk factors. Thus, Physicians and Dentists must be cautioned that other listed opportunistic fungal infections of oral cavity may also be seen among severe COVID-19 patients.be seen among severe COVID-19 patients.
“…Mucormycosis and other opportunistic infections among patients suffering and recovering from COVID-19 have emerged as a challenging health issue throughout the globe, specially more in India. [4][5][6] A case of post-COVID pulmonary mucormycosis is reported from Bangladesh 7 and to our knowledge, few more cases are diagnosed (un-published). Several factors are responsible for such an increased incidence of invasive fungal infections among patients recovering from COVID-19, which include severe pulmonary alveolar damages in COVID-19 that facilitate fungal invasion, immune dysregulations in COVID-19, invasive mechanical ventilations may facilitate entry of opportunistic pathogens, immunosuppressive drugs used in COVID-19, prolonged hospital stay and injudicious antibiotic prescription.…”
Opportunistic infections, especially invasive fungal infections have emerged as an added health issue in this COVID-era. The dysregulated immune mechanisms in the pathophysiology of COVID-19, its treatment with corticosteroids and other immunomodulatory agents, invasive mechanical ventilation and other forms of ventilatory and oxygen delivery systems, prolonged hospital stay, injudicious use of antimicrobials â all have set the required stages for such infections. Aspergillus spp. and Mucorales are ubiquitous, environmental fungus; may colonize in airways and chronically damaged human lungs, without significant health effects and cause disease, especially in immunocompromized patients. We report case history of a middle aged Bangladeshi man with multiple comorbidities, who presented with fever and respiratory symptoms, four-months after recovery from COVID-19. He had Aspergillus and Mucors on sputum microscopy and cultures; but his response to antibiotics suggested these were colonozations in previously injured lungs by tuberculosis in the form of fibrosis and bronchiectasis. He is well and free of symptoms, two-months since discharge.
BIRDEM Med J 2021; 11(3): 218-222
“…As steroid treatment results in immunosuppression, the spores easily enter the hosts system and germinate. The prevailing conditions in COVID-19 patients such as hyperglycemia and hyperferritinemia aid in rapid growth and multiplication of the fungal hyphae (Mahalaxmi et al 2021 ). Fig.…”
Section: Pathogenesis Of Mucormycosis and Cammentioning
The post-coronavirus disease (COVID-19) mucormycosis is a deadly addition to the pandemic spectrum. Although itâs a rare, aggressive, and opportunistic disease, the associated morbidity and mortality are significant. The complex interplay of factors aggravating CAM is uncontrolled diabetes, irrational and excessive use of antibiotics, steroids, and an impaired immune system. Recently, India has been witnessing a rapid surge in the cases of coronavirus disease-associated mucormycosis (CAM), since the second wave of COVID-19. The devastating and lethal implications of CAM had now become a matter of global attention. A delayed diagnosis is often associated with a poor prognosis. Therefore, the rapid and early diagnosis of infection would be life-saving. Prevention and effective management of mucormycosis depend upon its early and accurate diagnosis followed by a multimodal therapeutic approach. The current review summarizes an array of detection methods and highlights certain evolving technologies for early and rapid diagnosis of CAM. Furthermore, several potential management strategies have also been discussed, which would aid in tackling the neglected yet fatal crisis of mucormycosis associated with COVID-19.
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