tetano
Editor, Senior Moderator
Infection
. 2021 Jul 24.
doi: 10.1007/s15010-021-01670-1. Online ahead of print.
COVID-19 and mucormycosis superinfection: the perfect storm
Jaffar A Al-Tawfiq[SUP] 1 2 3 4 [/SUP], Saad Alhumaid[SUP] 5 [/SUP], Abeer N Alshukairi[SUP] 6 [/SUP], Mohamad-Hani Temsah[SUP] 7 [/SUP], Mazin Barry[SUP] 8 [/SUP], Abbas Al Mutair[SUP] 9 10 11 [/SUP], Ali A Rabaan[SUP] 12 [/SUP], Awadh Al-Omari[SUP] 13 14 [/SUP], Raghavendra Tirupathi[SUP] 15 16 [/SUP], Manaf AlQahtani[SUP] 17 18 19 [/SUP], Salma AlBahrani[SUP] 20 [/SUP], Kuldeep Dhama[SUP] 21 [/SUP]
Affiliations
Abstract
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.
Keywords: COVID-19; Mucormycosis; SARS-CoV-2.
. 2021 Jul 24.
doi: 10.1007/s15010-021-01670-1. Online ahead of print.
COVID-19 and mucormycosis superinfection: the perfect storm
Jaffar A Al-Tawfiq[SUP] 1 2 3 4 [/SUP], Saad Alhumaid[SUP] 5 [/SUP], Abeer N Alshukairi[SUP] 6 [/SUP], Mohamad-Hani Temsah[SUP] 7 [/SUP], Mazin Barry[SUP] 8 [/SUP], Abbas Al Mutair[SUP] 9 10 11 [/SUP], Ali A Rabaan[SUP] 12 [/SUP], Awadh Al-Omari[SUP] 13 14 [/SUP], Raghavendra Tirupathi[SUP] 15 16 [/SUP], Manaf AlQahtani[SUP] 17 18 19 [/SUP], Salma AlBahrani[SUP] 20 [/SUP], Kuldeep Dhama[SUP] 21 [/SUP]
Affiliations
- PMID: 34302291
- DOI: 10.1007/s15010-021-01670-1
Abstract
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.
Keywords: COVID-19; Mucormycosis; SARS-CoV-2.