The mucormycosis surge in COVID-19 pandemic: an analysis of associated risk factors and review of literature of reported cases

Abstract

<p class="abstract">COVID-19 patients are particularly susceptible to secondary infections, both bacterial and fungal, most likely due to immunological dysregulation. Secondary systemic mucormycosis was identified to be the significant cause of this epidemic among fungal infections. Post-COVID-19 complications are being reported all around the world, creating major pressure on healthcare services and the lives of the patients. PRISMA guidelines were used to conduct a literature review for articles published on COVID-19 associated Mucormycosis (CAM) between January 1, 2020, to May 18, 2021. The inclusion criteria were based on peer-reviewed studies in English covering cases with COVID-associated mucormycosis (CAM). Articles describing fungal coinfections that were not mucormycosis cases, non-COVID-19 cases, and studies with a lack of clarity were excluded from the review. The review includes 31 articles comprising of 21 Case Reports and 10 Case Series. Out of 104 cases, 76% were from India, 77.9% were males. Predisposing variables such as diabetes (71.15%), hypertension (37.5%), and ketoacidosis (10.6%) were found to be substantial contributors to the aggressive growth of opportunistic fungal infections such as mucormycosis. Rhino-orbital mucormycosis (n=47), followed by Rhino-orbital-cerebral mucormycosis (n=32), and Pulmonary mucormycosis (n=10) were commonly reported in the case studies and literature reviews which presented either following COVID-19 infection or a few weeks after active COVID-19 infection. Significant mortality (36.9%) was reported among patients. As per our observations, CAM could be a serious consequence of severe COVID-19, especially in people with uncontrolled diabetes.</p><p class="abstract"> </p>