Abstract
The rapid surge of COVID-19 cases in the second wave of the pandemic has crippled the healthcare delivery system in Nepal and neighboring countries. Unlike in the first wave of the pandemic, several cases of mucormycosis have been reported in patients with COVID-19 from Nepal and India. In this report, we briefly describe the clinical presentation, diagnosis, and risk factors for mucormycosis and explore why patients with COVID-19 are at an increased risk for developing the infection. As treatment of mucormycosis is challenging and consumes a lot of resources, prevention of mucormycosis is pivotal in low-income countries like Nepal. We also highlight some basic steps that are easy to perform and important to reduce the risk of infection.
Highlights
Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a wide range of disease patterns, from mild to life-threatening pneumonia to opportunistic bacterial and fungal coinfections
Though aspergillosis and candidiasis are the most commonly reported fungal infections in patients with COVID-19,2 mucormycosis is being reported at an unprecedented level
The reason why mucormycosis is common in patients with COVID-19 remains largely speculative
Summary
Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a wide range of disease patterns, from mild to life-threatening pneumonia to opportunistic bacterial and fungal coinfections. Though aspergillosis and candidiasis are the most commonly reported fungal infections in patients with COVID-19,2 mucormycosis is being reported at an unprecedented level. Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a wide range of disease patterns, from mild to life-threatening pneumonia to opportunistic bacterial and fungal coinfections.. Though aspergillosis and candidiasis are the most commonly reported fungal infections in patients with COVID-19,2 mucormycosis is being reported at an unprecedented level. A complex interplay of factors including poor glycemic control, acidic medium (metabolic acidosis, diabetic ketoacidosis), high iron level and decreased phagocytic activity of white blood cells (WBC) due to immunosuppression along with prolonged hospitalization with or without mechanical ventilation might facilitate mucormycosis.
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