Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India

Abstract

Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20 30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre existing diabetes mellitus. Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).