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Jochem B Buil1 
, Arthur R H van Zanten2 , Robbert G Bentvelsen3,4 , Tom A Rijpstra5 , Bram Goorhuis6 , Sanne van der Voort6 , Linda J. Wammes4 , Jeroen A Janson7 , Max Melchers2 , Moniek Heusinkveld8 , Willem J G Melchers1 , Ed J Kuijper4,9 , Paul E Verweij1,9
We describe four secondary fungal infections caused by Mucorales species in COVID-19 patients. Three COVID-19 associated mucormycosis (CAM) occurred in ICU, one outside ICU. All were men aged > 50 years, three died. Clinical presentations included pulmonary, rhino-orbital cerebral and disseminated infection. Infections occurred in patients with and without diabetes mellitus. CAM is an emerging disease and our observations underscore the need to be aware of invasive mucormycosis, including in COVID-19 patients without (poorly controlled) diabetes mellitus and outside ICU.
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, Arthur R H van Zanten2 , Robbert G Bentvelsen3,4 , Tom A Rijpstra5 , Bram Goorhuis6 , Sanne van der Voort6 , Linda J. Wammes4 , Jeroen A Janson7 , Max Melchers2 , Moniek Heusinkveld8 , Willem J G Melchers1 , Ed J Kuijper4,9 , Paul E Verweij1,9 We describe four secondary fungal infections caused by Mucorales species in COVID-19 patients. Three COVID-19 associated mucormycosis (CAM) occurred in ICU, one outside ICU. All were men aged > 50 years, three died. Clinical presentations included pulmonary, rhino-orbital cerebral and disseminated infection. Infections occurred in patients with and without diabetes mellitus. CAM is an emerging disease and our observations underscore the need to be aware of invasive mucormycosis, including in COVID-19 patients without (poorly controlled) diabetes mellitus and outside ICU.
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