Mucormycosis in COVID-19: A systematic review of literature

Abstract

Coronavirus disease 2019 (COVID-19) is an acute viral illness caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Opportunistic infections such as mucormycosis have been reported among CO-VID-19 patients particularly in South Asian countries during the second wave of this pandemic. It is necessary to re-evaluate any changes in traditional risk factors associated with mucormycosis such as diabetes mellitus, organ transplant, etc in the precedent of ongoing COVID-19 pandemic. We conducted a systematic review using electronic databases. A total of 115 COVID-19 patients who were diagnosed with mucormycosis were included in this study. Diabetes mellitus was the most common co-morbidity with 77.1%, followed by hypertension (29.5%) and renal disease (14.3%). 55.2% of the patients had received dexamethasone for COVID-19 infection. Ten patients (11.5%) had received tocilizumab. Sinuses were the most common site of mucormycosis among COVID-19 patients at 79.4% with maxillary sinus (47.4%) being most commonly infected. Orbits were SUMMARY the second most prevalent site at 56.7% and lungs were infected with mucor at 11.3%. The mean duration between the diagnosis of COVID-19 infection and mucormycosis was 16.15 days (range 2-90 days). Cavernous sinus was either infiltrated or encased in 14 patients (14.4%). Cerebral involvement was seen in terms of abscess, infarcts, or edema in 12 patients (12.4%). Only 76 patients had data on the outcomes, out of which 37 (48.7%) patients had died. Diabetes mellitus is still the most common co-morbidity similar to non-COVID-19 patients. More than 90% of the patients with COVID-19 infection had received steroids. Complications such as cavernous sinus thrombosis, cerebral infarcts, abscesses were common. Indiscriminate use of steroids in patients needs to be avoided and focus needs to be put on tight blood sugar control in diabetic patients. Studies are needed to confirm the role of the SARS-CoV-2 virus in causing immune dysfunction and mucormycosis.

The Psychological Impact of Rhino-Orbital Mucormycosis During the Second Wave of COVID-19 Pandemic From South East Asian Country

“…We also observed a male preponderance (62.95%) in the patients who presented to us. This observation goes hand in hand with the existing epidemiological studies on mucormycosis in literature [3,[17][18][19][20].…”

Gastrointestinal Fungal Co-Infection Complicating the Course of COVID 19 Infected Post-Surgical Infant

“…The morbidity and mortality may significantly reduce by early identification of fungal infections. The fungal infections are commonly seen in the nasal sinuses followed by orbit and lungs [2]. Gastrointestinal fungal infections in COVID 19 are rare and there are only few case reports in the adult age group and none in the infant age group.…”

Comparative Evaluation Of Knowledge And Awareness About Mucormycosis In Dental And Medical Practitioners In Western Maharashtra

“…The incidence varies from 0.005 to 1.7 per million population, and the global case fatality is as high as 46%. (7) Considering the mortality rate, it is crucial to make dental and medical practitioners capable of identifying the disease, in order to rule out the disease in its early stage. Understanding and assessing the knowledge and awareness regarding mucormycosis is valuable in this regard.…”