COVID-19 associated mucormycosis and COVID-19 vaccination status


  • Ashwini Godse Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Pruthvi Raj Shivalingaiah Department of Otorhinolaryngology, Shri Atal Bihari Vajpayee Medical College and Research Institute, Bangalore, Karnataka, India
  • Zaaraasmat Ahesannawaz Mujahid Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Manjula Kalyanapura Gurumurthy Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Yumna Beegum Elachola Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Jewel Christy Johnson Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India



COVID-19 associated mucormycosis, COVID-19 vaccine, Covaxin, Covishield, Mucormycosis


Background: Mucormycosis is lethal angio invasive fungal infection affecting mainly the immunocompromised individuals. During second wave of COVID-19 pandemic there was rise in number of rhino-orbito-cerebral (ROCM) cases in both COVID-19 affected patients and patients who recovered from COVID-19 infection. This study was conducted to know the anatomical site and extent of involvement in head and neck region in both COVID-19 vaccinated and unvaccinated individuals.

Methods: A retrospective descriptive study was conducted between May 2021 and November 2021 at Bowring and lady Curzon hospital, Shri Atal Bihari Vajpayee medical college and research institute, Bangalore, Karnataka, India. 358 patients with post-covid RTPCR negative rhino-orbital mucormycosis were included in the study. The demographic data, COVID-19 vaccination status and anatomical sites of involvement in the patients was collected and analysed.

Results: 4 (1.11%) patients were fully vaccinated with 2 doses of covid vaccine, 18 (5.02%) patients were partially vaccinated, 336 (93.85%) were unvaccinated.  Majority of the patients were in the age group of 41-60 years in all the groups. In unvaccinated group, majority of the patients presented with stage II/III disease (48.51%; 39.88% respectively) and 39 (11.60%) patients with stage IV ROCM.

Conclusions: The extent and severity of ROCM was higher in COVID-19 unvaccinated patients as compared to vaccinated group. Further studies are required to determine the role of COVID-19 vaccine in reducing the severity of the of ROCM.


Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med 2021;42:264.e5-8,

Prakash H, Chakrabarti A. Epidemiology of Mucormycosis in India. Microorganisms. 2021;9(3):523.

Dyer O. Covid-19: India sees record deaths as “black fungus” spreads fear. BMJ. 2021;373.

Sharma R, Gujarat: with scarcity, fungus experts suggest alternative drugs. Available from: www://Timesofindia.Indiatimes.Com/Articleshow/82813984.Cms?Utm_Source=Contentofinterest&Utm_Medium=Text&Utm_Campaign=Cppst.Times Of India. Accessed on 25 April 2021.

Mehta S, Pandey A. (2020) Rhino-orbital mucormycosis associated with COVID-19. Cureus. 2020;12:e10726.

Prakash H, Ghosh AK, Rudramurthy SM, Singh P, Xess I, Savio J, et al. A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Med Mycol. 2019;57(4):395-402.

“World’s largest vaccination programme begins in India on January 16”. The Hindu. 15 January 2021. Available from: Accessed on 16 January 2021.

“Coronavirus Registration for next phase of vaccination on Co-WIN 2.0 portal to open on March 1”. The Hindu. 28 February 2021. Available from: Accessed on 1 May 2021.

“CoWin Upgrade, 50 Lakh Daily Target: What to expect as India vaccinates citizens above 45. 3 April 2021. Available from: Accessed on 27 April 2021.

Koshy J. “Vaccines for all above 18 from May 1; States can buy directly”. The Hindu. Available from: from-may-1-everyone-over-18-years-eligible-for-covid-19-vaccination-government/article34359940.ece. Accessed on 25 April 2021.

Patel A, Agarwal R, Rudramurthy SM, Shevkani M, Xess I, Sharma R, et al. Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India. Emerg Infect Dis. 2021;27(9):2349.

Donnelly J, Chen S, Kauffman C, Steinbach W, Baddeley J, Verweij P, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2019:71(6):1367-76.

Honavar SG. Code Mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian J Ophthalmol. 2021;69:1361-5.

Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41:634-53.

Musuuza JS, Watson L, Parmasad V, Putman-Buehler N, Christensen L, Safdar N. Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: a systematic review and meta-analysis. PLoS One. 2021;16(5):e0251170.

Dravid A, Kashiva R, Khan Z, Bande B, Memon D, Kodre A, et al. Epidemiology, clinical presentation and management of COVID-19 associated mucormycosis: a single center experience from, Pune, Western India. Mycoses. 2022;65(5):526-40.

Selarka L, Sharma S, Saini D, Sharma S, Batra A, Waghmare VT, et al. Mucormycosis and COVID‐19: an epidemic within a pandemic in India. Mycoses. 2021;64(10):1253-60.

Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP. Pathogenesis of mucormycosis. Clin Infect Dis. 2012;54(suppl_1):S16e22.

Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: a systematic review of cases reported worldwide and in India. Diabetes Metab Syndr Clin Res Rev. 2021;15(4):102146.




How to Cite

Godse , A., Raj Shivalingaiah, P., Mujahid, Z. A., Kalyanapura Gurumurthy, M., Elachola, Y. B., & Johnson, J. C. (2023). COVID-19 associated mucormycosis and COVID-19 vaccination status. International Journal of Research in Medical Sciences, 11(5), 1682–1686.



Original Research Articles