Title of the Article: Paranasal Mucormycosis in COVID-19 Patient

Saldanha, Marina; Reddy, R. Govind; Vincent, Mark Jittu

doi:10.1007/s12070-021-02574-0

Cited by 78 publications

(53 citation statements)

References 12 publications

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“…The true incidence of rhino-orbital mucormycosis in COVID-19 patients is not known. However, there are multiple case reports describing mucormycosis in COVID-19 and most of these case reports are presently from India, especially in COVID-19 treated and recovered patients those were diabetic and corticosteroids were administered injudiciously for controlling severity of COVID-19, leading to a higher fatality in such cases and complicating the pandemic scenario [ 17 , 18 , 24 – 37 ].…”

Section: Incidence and Prevalencementioning

confidence: 99%

Section: Clinical Features and Managementmentioning

confidence: 99%

“…Literature review identified 30 publications of case reports and case series of mucormycosis among COVID-19 patients [ 24 – 26 , 30 , 31 , 33 – 37 , 40 – 55 ]. Of all the reports, 11 publications were from India [ 24 – 26 , 30 – 37 ]. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis[ 24 – 26 , 30 , 32 – 37 , 40 , 42 , 45 , 47 , 52 – 54 ].…”

Section: Clinical Features and Managementmentioning

confidence: 99%

“…Of all the reports, 11 publications were from India [ 24 – 26 , 30 – 37 ]. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis[ 24 – 26 , 30 , 32 – 37 , 40 , 42 , 45 , 47 , 52 – 54 ]. Other presentations included pulmonary [ 31 , 41 , 43 , 44 , 49 , 51 , 55 ], cutaneous [ 46 ], disseminated [ 56 ] and gastrointestinal [ 48 ] diseases.…”

Section: Clinical Features and Managementmentioning

confidence: 99%

“…[ 24 , 31 , 36 , 41 – 44 , 47 , 49 , 51 , 55 ] and the others were reported as unspecified Mucorale [ 25 , 26 , 30 , 33 – 35 , 37 , 40 , 45 , 48 , 50 , 52 , 54 ]. The management of mucormycosis is usually difficult and requires urgent medical and surgical debridement while the choice of drug to treat mucormycosis is Amphotericin B [ 23 , 57 ] and Amphotericin was used in 23 of the included studies [ 24 – 26 , 30 – 37 , 40 – 44 , 46 , 47 , 49 – 54 ] and surgical debridement was reported in 20 of the included studies [ 24 – 26 , 30 , 32 – 37 , 40 , 44 – 47 , 50 – 54 ]. The majority of the included patients in this review underwent surgical resection/debridement [ 24 – 26 , 30 , 32 – 37 , 40 , 44 – 47 , 50 – 54 ].…”

Section: Clinical Features and Managementmentioning

confidence: 99%

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COVID-19 and mucormycosis superinfection: the perfect storm

et al. 2021

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Background The recent emergence of the Coronavirus Disease (COVID-19) disease had been associated with reports of fungal infections such as aspergillosis and mucormycosis especially among critically ill patients treated with steroids. The recent surge in cases of COVID-19 in India during the second wave of the pandemic had been associated with increased reporting of invasive mucormycosis post COVID-19. There are multiple case reports and case series describing mucormycosis in COVID-19. Purpose In this review, we included most recent reported case reports and case-series of mucormycosis among patients with COVID-19 and describe the clinical features and outcome. Results Many of the mucormycosis reports were eported from India, especially in COVID-19 patients who were treated and recovered patients. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis. Those patients were diabetic and had corticosteroids therapy for controlling the severity of COVID-19, leading to a higher fatality in such cases and complicating the pandemic scenario. The triad of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), corticosteroid use and uncontrolled diabetes mellitus have been evident for significant increase in the incidence of angioinvasive maxillofacial mucormycosis. In addition, the presence of spores and other factors might play a role as well. Conclusion With the ongoing COVID-19 pandemic and increasing number of critically ill patients infected with SARS-CoV-2, it is important to develop a risk-based approach for patients at risk of mucormycosis based on the epidemiological burden of mucormycosis, prevalence of diabetes mellitus, COVID-19 disease severity and use of immune modulating agents including the combined use of corticosteroids and immunosuppressive agents in patients with cancer and transplants.

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Section: Incidence and Prevalencementioning

confidence: 99%

Section: Clinical Features and Managementmentioning

confidence: 99%

Section: Clinical Features and Managementmentioning

confidence: 99%

Section: Clinical Features and Managementmentioning

confidence: 99%

Section: Clinical Features and Managementmentioning

confidence: 99%

See 3 more Smart Citations

COVID-19 and mucormycosis superinfection: the perfect storm

et al. 2021

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Emerging cases of mucormycosis under COVID‐19 pandemic in India: Misuse of antibiotics

Gupta

Roshan

Singh

et al. 2021

Drug Development Research

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COVID‐19's second wave had a significant impact on India, on May 7, 2021, the largest daily recorded case count was a little more than 4 million, and it has since fallen. Although the number of new cases reported has dropped, during the third week of May 2021, India accounted for about 45% of new cases identified globally and around 34% of deaths. As India maintains its present level of stability, a new urgent threat has emerged in the form of coronavirus‐associated mucormycosis. Mucormycosis, an acute and deadly fungal infection caused by Mucorales‐related fungal species, is a fungal emergency with a particularly aggressive propensity for contiguous spread, associated with a poor prognosis if not properly and immediately identified, and treated. Mucormycosis, sometimes referred to as the “black fungus,” has increased more rapidly in India during the second wave of COVID‐19 than during the first wave, with at least 14,872 cases as of May 28, 2021. Uncontrolled diabetic mellitus (DM) and other immunosuppressive diseases such as neutropenia and corticosteroid treatment have traditionally been identified as risk factors for mucormycosis. Therefore, the use of glucocorticoids or high doses of glucocorticoids in mild COVID‐19 cases (without hypoxemia) should be avoided. In addition, drugs that target the immune pathway, such as tocilizumab, are not recommended without clear benefits.

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

SeyedAlinaghi

Barzegary

Pashaei

et al. 2022

Health Science Reports

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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.

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Title of the Article: Paranasal Mucormycosis in COVID-19 Patient

Cited by 78 publications

References 12 publications

COVID-19 and mucormycosis superinfection: the perfect storm

COVID-19 and mucormycosis superinfection: the perfect storm

Emerging cases of mucormycosis under COVID‐19 pandemic in India: Misuse of antibiotics

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

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