Mucormycosis and COVID-19- black threat of the pandemic

Abstract

Background: Cases of mucormycosis in people with COVID-19 have been increasingly reported world-wide, particular from India. Globally, the prevalence varied from 0.005 to 1.7 per million population. The aim of the study was to determine the effect of mucormycosis in COVID-19 patients.

Methods: A retrospective study was conducted on 30 patients with biopsy-proven mucormycosis with RT-PCR-confirmed COVID-19 from May 21 to April 2022. Clinical and paraclinical data including demography, underlying diseases, clinical features, corticosteroid use, sites of infection, co-infections, the time between COVID-19 and mucormycosis, clinical management were recorded.

Results: Data from a total of 30 patients post covid mucormycosis was analyzed. The majority of patients were male 70%, age group 30-55 years and were immunocompromised. All of them were diabetic. 80% patients had severe COVID-19 illness. 20% had mild-moderate infection. The average interval between COVID-19 infection and mucormycosis was 15-35 days. The most common was rhinorbital cerebral infection followed by pulmonary involvement. 2 patients had cutaneous mucormycosis. Systemic antifungals were used in all the patients. 12 out of 20 patients with rhinorbital cerebral mucormycosis underwent reconstructive surgery. Debridement was done in 2 patients with mucormycosis.

Conclusions: Our study concludes that CAM (COVID-19 associated mucormycosis) is associated with high mortality and morbidity. Systemic steroids are helpful in people with severe COVID-19 infection but they can also predispose them to secondary fungal diseases. Timely diagnosis and management are challenging but can be helpful if there is an early diagnosis of infection and control of comorbid conditions.