ABSTRACT
Introduction: Mucormycosis is a life-threatening angio-invasive infection caused by fungi of the order Mucorales. In India, the second wave of the COVID pandemic, primarily driven by the delta variant, led to a surge in cases of mucormycosis. The majority of these cases occurred following recovery from COVID, and resulted in increased morbidity and mortality. Here we present a series of five kidney transplant recipients (KTR’s) who presented with COVID-related mucormycosis. Methods: This is a single-centre, prospective, observational study that included all KTRs who presented to Madras Medical College with COVID-related mucormycosis between May 2021 and August 2021. Relevant clinical details and laboratory data were collected, therapeutic interventions were recorded, and outcomes of hospitalization were noted. Results: Five patients developed COVID-related mucormycosis during the study period. Their clinical details and hospital course are summarized in Table 1. Only one patient had received COVID vaccination (2 doses of covishield). All patients had underlying post-transplant diabetes mellitus, with severe hyperglycemia at admission. They all received intravenous dexamethasone for COVID pneumonia. Mucormycosis developed 10-21 days after recovery from COVID in four patients;one patient developed both infections concurrently. All patients received liposomal Amphotericin B, with four patients also undergoing functional endoscopic sinus surgery (FESS). Acute graft dysfunction occurred in all five patients;three had complete renal recovery, one had partial renal recovery, and one patient died during hospitalisation. [Formula presented] Conclusions: All five KTR’s in our series who developed COVID-related mucormycosis had acute graft dysfunction. They all had multiple risk factors that included elements of hyperglycemia, sepsis and nephrotoxic drugs (amphotericin B). Four of our five patients recovered, with only one case succumbing to the infection No conflict of interest