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1.
Mol Biol Rep ; 49(6): 4977-4988, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1930488

ABSTRACT

Mucormycosis, also called "Black Fungus", is a new cause for worry in the current Coronavirus disease 2019 (covid-19) pandemic. Mucormycosis is devasting due to its high rate of morbidity and mortality which is a great cause of concern. Mucormycosis, in general, affects immunocompromised patients including diabetic, people with malignancies, organ and stem cell transplants and people affected with pandemic diseases like covid-19. Diagnosis of Mucormycosis is often delayed either due to clinical complications or misdiagnosed as symptoms of other diseases, especially covid-19. This could delay the treatment protocol which results in the failure of treatment. Mortality rate due to secondary infections in covid-19 patients with uncontrolled diabetics and who are on steroid therapy can soon reach 100% if diagnosis and treatment doesn't happen on timely basis. Risk of Mucormycosis is not just in immunosuppressed patients, but immunocompetent people with late diagnosis are also prone to infection. In view of this, we present a comprehensive review on risks of Mucormycosis in immunocompromised and immunocompetent patients highlighting the epidemiology, forms of Mucormycosis, immune response against Mucorales, difficulties in diagnosis and challenges in treatment of Mucormycosis, with emphasis on covid-19 associated Mucormycosis. Importantly, we have discussed the precautions and care to effectively manage Mucormycosis in immunocompromised and immunocompetent patients. Thus, current review helps clinicians in understanding various risk factors in both immunocompromised (especially covid-19 patients) and immunocompetent patients which is critical in managing Mucormycosis in current covid-19 pandemic.


Subject(s)
COVID-19 , Mucorales , Mucormycosis , Humans , Immunocompromised Host , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Pandemics
2.
Indian J Ophthalmol ; 70(6): 2163-2168, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1875907

ABSTRACT

Purpose: An unprecedented surge has been noted in rhino-orbital-Cerebral mucormycosis (ROCM) in times of current COVID-19 pandemic. The present prospective study aims to evaluate clinico-epidemiological profile, risk factors, management, and outcome of the cases of ROCM that presented to our tertiary care center during the study period from April to June 2021. Methods: All patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were staged and were treated with intravenous liposomal amphotericin B (AMB) and sino-nasal debridement of local necrotic tissue. Transcutaneous retrobulbar AMB (TRAMB), orbital decompression, and exenteration were instituted as indicated. All patients were followed up for a minimum of 6 months before arriving at the final outcome. Statistical analysis was performed. Results: A total of 49 patients presented during the study period, with a mean age of 42.2 years. The major risk factors included uncontrolled diabetes (89.8%), COVID-19 positivity (51.02%), and concurrent steroid use (38.77%). The most common presenting symptom was facial pain/swelling (43.65%), while the most common presenting sign was deterioration in vision (75.51%). Intravenous liposomal AMB was given to all patients along with sino-nasal debridement (85.71%), TRAMB (57.14%), orbital decompression (14.28%), and exenteration (12.24%). Overall, mortality at 6 months was 22.45% (11 patients). Age more than 60 years, intracranial extension, and HbA1c of more than 8.0% were observed to be statistically significant indicators of mortality. Conclusion: Early suspicion and timely diagnosis of mucormycosis at rhino-orbital stage is warranted in order to salvage life as well as visual function. TRAMB may prove as potentially favorable treatment modality in cases with limited orbital involvement.


Subject(s)
COVID-19 , Eye Diseases , Mucormycosis , Orbital Diseases , Adult , Antifungal Agents/therapeutic use , COVID-19/complications , COVID-19/epidemiology , Eye Diseases/complications , Humans , India/epidemiology , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Orbital Diseases/diagnosis , Orbital Diseases/epidemiology , Orbital Diseases/therapy , Pandemics , Prospective Studies , Tertiary Care Centers
3.
Indian J Ophthalmol ; 70(6): 2158-2162, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1875904

ABSTRACT

Purpose: To study the awareness on mucormycosis among outpatients who visited six tertiary eye care hospitals at Madurai, Pondicherry, Coimbatore, Tirunelveli, Chennai, and Tirupati. Methods: This was a telephone-based survey conducted using questionnaires consisting of 38 questions in five sections from July 5 to 25, 2021. Patients visiting the eye hospitals for an examination were contacted over their phones and responses were directly entered onto the Google forms platform. Results: A total of 4573 participants were included in the study. Among all participants, a cumulative 83% of participants had some knowledge of mucormycosis. More than 80% of them reported that their prime source of information was through mass communication like television or radio. Around 34.8% of the respondents were aware that it can occur after treatment for coronavirus disease 2019 (COVID-19) infection, only half of them (54.3%) knew that systemic steroids were the main risk factor. The knowledge scores were higher for participants who were diabetics (n = 1235) or had been affected by COVID-19 earlier (n = 456) or whose friends had mucormycosis earlier (n = 312). Knowledge, attitude, and practice (KAP) scores of nonprofessional health-care workers (n = 103) were much better compared to patients. Conclusion: Such KAP studies give us an idea of the impact of the measures taken for educating the public. In this study, a cumulative 83% of participants had some knowledge of mucormycosis and 86% knew that this was an emergency. More than 50% of the participants were not aware that diabetes is a risk factor for mucormycosis.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , COVID-19/epidemiology , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Hospitals , Humans , India/epidemiology , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Surveys and Questionnaires
4.
J Pak Med Assoc ; 72(5): 1017, 2022 05.
Article in English | MEDLINE | ID: covidwho-1863753
5.
J Prim Care Community Health ; 13: 21501319221099476, 2022.
Article in English | MEDLINE | ID: covidwho-1854739

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2, which is known for the multiple mutations and forms that have rapidly spread across the world. With the imminent challenges faced by low- and middle-income countries in curbing the public health fallbacks due to limited resources, mucormycosis emerged as a fungal infection associated with high mortality. In this rapid review, we explored MEDLINE, Cochrane, Web of Science, WHO Global Database, and the search engine-Google Scholar for articles listed until July 2021 and presented a narrative synthesis of findings from 39 articles. The epidemiology, causative factors, incidence parameters, pharmacological treatment, and recommendations for low- and middle-income countries are enlisted. This study concludes that a majority of the globally reported COVID-19 associated mucormycosis cases stemmed from India. Individuals receiving systemic corticosteroids or who have a history of diabetes mellitus are more prone to contracting the disease. Public health authorities in LMIC are recommended to strengthen antifungal therapies for COVID-19 associated mucormycosis and to strategize reduction in diabetes mellitus prevalence.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Humans , India/epidemiology , Mucormycosis/complications , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2
6.
J Assoc Physicians India ; 70(4): 11-12, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1801757

ABSTRACT

The recent second wave of COVID-19 cases in India has been marked by an unexpected increase in cases of mucormycosis reported in the context of COVID illness. Herein we aim to identify risk factors that may explain the sudden surge of cases and help develop preventive strategies. MATERIAL: We performed a case-control study comparing cases diagnosed with CAM and those who had recovered from COVID-19 without developing mucormycosis (controls). Information on comorbidities, glycemic control, and practices related to COVID-19 treatment was recorded. OBSERVATION: 100 patients of CAM (cases) and 150 patients of COVID-19 without mucormycosis (controls) were included in the study. The spectrum of involvement of CAM cases included rhino-sinus (n=98, 98%), rhino orbital (n=58, 58%), rhino-orbito-cerebral (n=29, 29%). In CAM group symptoms of mucormycosis began a mean of 13.46 days after onset of COVID-19. The mean age of the CAM study group was 51.16 years with 69 males (69%) and 31 females (31.0). The most frequent comorbidities seen in our study population was diabetes (n=113, 45.2%) and hypertension (n=54, 21.6%). Diabetes was significantly more frequent among cases than controls (89% vs 24%, p <0.001). 31% of patients in CAM case group showed a common practise of steam inhalation during covid illness. Most common symptom reported in CAM was related to the eye which included eye pain (58%), lid swelling (54%), eye swelling (47%). Sino-nasal symptoms were nasal discharge (25%), nasal stuffiness (21%), and epistaxis (4%). Other common symptoms were headache (51%) and facial pain (36%). On examination of nasal cavity, crusting and ulceration were present in 83% patients. Eye involvement was present in 60% of cases, of which 27% of cases had vision loss. For definitive diagnosis of CAM, Potassium hydroxide (KOH) mount was positive for aseptate hyphae in 31 patients (31%). Use of systemic steroids for the management of COVID-19, was more frequent in CAM case group than control group (n=70, 70%). The CAM case group showed mean Hba1c of 10.7 ± 2.45, mean Serum Iron levels was 49.01 ± 18.69, mean ferritin was 913.37, mean CRP was 131.56 and mean LDH was 428.70. CONCLUSION: Overzealous use of steroids, uncontrolled sugars and repeated steam inhalation provided a favourable environment for the growth of mucormycosis. Judicious use of steroids and stringent glycemic control are vital to preventing mucormycosis.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , COVID-19/drug therapy , COVID-19/epidemiology , Case-Control Studies , Diabetes Mellitus/epidemiology , Female , Humans , India/epidemiology , Male , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2 , Steam
7.
Acta Medica (Hradec Kralove) ; 64(4): 227-231, 2021.
Article in English | MEDLINE | ID: covidwho-1743012

ABSTRACT

Coronavirus infectious disease-19 caused by Severe acute respiratory distress syndrome-coronavirus-2 has emerged to be an emergency global health crisis for more than a year. And, as the disease has spread, a number of new clinical features have been observed in these patients. Immunosuppression caused by this disease results in an exacerbation of pre-existing infections. While corticosteroids are considered a life-saving therapeutic intervention for this pandemic, they have proved to be a double-edged sword and their indiscriminate use has produced some deleterious results. Recently, in the backdrop of this expression, a notable rise in invasive fungal infections has been identified even in the post-remission phase. Mucormycosis, Aspergillosis, and Candidiasis are the three most common opportunistic fungal infections among those observed. COVID-19 patients with diabetes mellitus are already at a higher risk of developing such secondary infections due to impaired immunity. Here we present a rare case report of a 50-year old male diabetic mellitus patient diagnosed with dual fungal infections (Aspergillosis along with Mucormycosis) leading to maxillary sinusitis as a post-COVID manifestation. To our knowledge, this is the first such case reported till date.


Subject(s)
Aspergillosis , COVID-19 , Diabetes Mellitus , Maxillary Sinusitis , Mucormycosis , Mycoses , Aspergillosis/complications , Aspergillosis/diagnosis , Aspergillosis/therapy , COVID-19/complications , Humans , Male , Maxillary Sinusitis/complications , Middle Aged , Mucormycosis/complications , Mucormycosis/diagnosis , Mucormycosis/therapy , Mycoses/complications , SARS-CoV-2
8.
Eur Arch Otorhinolaryngol ; 279(6): 3201-3210, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1669788

ABSTRACT

AIM: During the second wave of COVID-19, cases of mucormycosis were increased suddenly over a period of 3 months in Maharashtra, India. An attempt was made to study the clinical profile and risk factors associated with mucormycosis. MATERIALS AND METHODS: A retrospective descriptive study was carried out at a tertiary hospital during May 2021-July 2021. After obtaining informed written consent from the participants, various details of all participants, such as diabetes mellitus, use of steroids in COVID-19 treatment, use of immunosuppressant drugs, oxygen therapy, use of ventilators, complications that occurred during treatment, etc., were noted. All mucormycosis patients were treated with amphotericin B and aggressive surgical treatment. RESULTS: In the present study, 74.7% of mucormycosis patients were male. 77.4% of mucormycosis patients were above 40 years of age. 6.7% of mucormycosis patients were partially vaccinated. Among risk factors, 86.6% had diabetes mellitus, 84% had COVID-19 infection, 44% had received steroids, and 54.7% had received oxygen. 80% of patients were present during and within 1 month of COVID-19 infection. 52% of patients were presented in stage III and 41.3% were presented in stage II. Despite aggressive surgical debridement along with amphotericin B, mortality was 25.33%. 5.3% of patients had brain abscesses, 8% of patients had cavernous sinus thrombosis, 4% of patients had facial nerve palsy and 1.3% of patients had meningitis. CONCLUSION: Mucormycosis was predominantly seen in male above the age of 40 years COVID-19 infection and diabetes mellitus was common risk factor for mucormycosis.


Subject(s)
COVID-19 , Mucormycosis , Orbital Diseases , Adult , Amphotericin B/therapeutic use , COVID-19/drug therapy , COVID-19/epidemiology , Female , Humans , India/epidemiology , Male , Mucormycosis/complications , Mucormycosis/epidemiology , Mucormycosis/therapy , Orbital Diseases/therapy , Oxygen , Pandemics , Retrospective Studies , Steroids/therapeutic use , Tertiary Care Centers
9.
Mol Biol Rep ; 49(4): 3349-3356, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1640943

ABSTRACT

The COVID-19 patients, both infected and recovered are rapidly contracting mucormycetes infections due to the 'Mucorales' order, under Zygomycetes class of fungi. The mucorales fungi commonly known to exist in our natural surroundings including soil, but the frequency of incidences was never rampant. This sudden spike in infections, is locally known as 'black fungus,' and is affecting various organs, including- eyes, sinuses, nose, brain, skin, intestine, lungs, etc. The severity of situation is ascertainable from the fact that, in certain cases surgical eye/jaws removal persists as the only viable option to avert mortality, as therapeutic interventions are limited. This epidemic situation intrigued experts to investigate the probable reason behind this unpredicted escalation in reported cases, including in recuperated COVID-19 patients, as person-to-person spread of infection is not common. The comparison of physiological parameters in healthy and COVID-19 afflicted patients highlights that the underlying conditions including diabetes mellitus, steroidal therapy, lymphopenia (decreased CD4+ and CD8+ lymphocytes), deregulated cytokine release storm, elevated free iron levels (hemosiderosis) in blood and insulin insensitivity are playing major roles in deteriorating conditions in rarely pathogenic fungal infections. This review is an attempt to explain the rationalities that makes people vulnerable to mucormycetes infection.


Subject(s)
Mucorales/immunology , Mucormycosis , SARS-CoV-2/immunology , COVID-19/complications , COVID-19/microbiology , COVID-19/mortality , COVID-19/therapy , Diabetes Mellitus/immunology , Diabetes Mellitus/mortality , Humans , Mucormycosis/etiology , Mucormycosis/immunology , Mucormycosis/mortality , Mucormycosis/therapy
11.
JAMA Ophthalmol ; 140(1): 66-72, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1561895

ABSTRACT

Importance: An outbreak of COVID-19-associated rhino-orbitocerebral mucormycosis (CAM) has occurred in many parts of the world. Although the clinical profile and risk factors for CAM have been studied, cumulative mortality and its risk factors have not. Objective: To report the cumulative mortality rates at different times in cases with CAM and identify risk factors for CAM-associated mortality. Design, Setting, and Participants: This retrospective case-control study was conducted from March 1 to May 30, 2021, in a tertiary care multispecialty hospital in western India. All patients diagnosed with CAM and with a minimum follow-up of 30 days or those who died before 30 days due to CAM were included. Main Outcomes and Measure: Cumulative mortality in CAM using survival analysis. Results: A total of 73 consecutive patients with CAM with a mean (SD) age of 53.5 (12.5) years were included in the analysis, of whom 48 (66%) were men. CAM developed at a median of 28 (IQR, 15-45; range, 4-90) days after recovery from COVID-19. Of the 73 patients with CAM, 26 (36%) died; the cumulative probability of death was 26% (95% CI, 16%-41%) at day 7 and doubled to 53% (95% CI, 39%-69%) at day 21. Sinus debridement was performed in 18 of 51 patients (35%), and 5 of 52 (10%) underwent exenteration, whereas intravenous lyophilized amphotericin B was administered to 48 patients (66%). A multivariate Cox proportional hazards regression analysis showed that receiving mechanical ventilation in the past was associated with a nearly 9-fold increased risk of death (hazard ratio [HR], 8.98; 95% CI, 2.13-38.65; P = .003), and patients who had visual acuity of light perception or better had a 46% lower risk of death (HR, 0.56; 95% CI, 0.32-0.98; P = .04). Intravenous amphotericin B administration was associated with a reduced rate of exenteration (0 vs 5 of 25 [20%]; P < .001). On multivariate analysis, those who received intravenous amphotericin B had a 69% reduced risk of death (HR, 0.31; 95% CI, 0.06-1.43; P = .13). Conclusions and Relevance: These findings suggest that the mortality rate after rhino-orbitocerebral mucormycosis is high and that a subgroup of patients with severe COVID-19 or presenting with severe orbital disease are more likely to die within 10 days of admission.


Subject(s)
COVID-19 , Mucormycosis , Antifungal Agents/therapeutic use , Case-Control Studies , Humans , Male , Middle Aged , Mucormycosis/drug therapy , Mucormycosis/therapy , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers
13.
Indian J Ophthalmol ; 69(12): 3678-3683, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1538657

ABSTRACT

PURPOSE: To report the incidence, cumulative mortality, and factors influencing the outcomes from a large series of COVID-19-associated mucormycosis (CAM) from western India. METHODS: Consecutive patients with CAM between March 1 and May 10, 2021, with a minimum follow-up of 1 month were included. We recorded the presence of diabetes, use of steroids, and need for non-invasive ventilation (NIV) from the case files. The features of orbital involvement, treatment administered, and outcomes, i.e., death, orbital exenteration, or recovery were noted. Cumulative probability of adverse outcomes, defined as either death or exenteration, was reported using survival analysis. RESULTS: We treated 67 cases of CAM and found an incidence of 13.6 cases per 1,000 patients post-moderate to severe COVID-19. Uncontrolled diabetes (90%) with ketoacidosis (40%) and prior systemic steroids (84%) were the strongest predispositions. The onset of CAM was 15.1 ± 9.5 days (range: 6-42 days) after recovery from COVID-19. The cumulative probability of an adverse outcome was 38% (95% confidence intervals [CI] = 23.7-56.9%) on day 20. The patients who required NIV during COVID-19 were at seven times higher risk of experiencing an adverse outcome (hazard ratios [HR] = 6.92, 95% CI = 2.9-16.2) while those who received amphotericin- -B had a 61% lower risk (HR = 0.39, 95% CI = 0.16-0.97). CONCLUSION: The current outbreak of CAM was seen predominantly in uncontrolled diabetics, especially with ketoacidosis and steroid intake. The cumulative probability of death or orbital exenteration was 38% at day 20 of the infection and those who required NIV and did not receive amphotericin-B were at a high risk of these outcomes.


Subject(s)
COVID-19 , Mucormycosis , Antifungal Agents/therapeutic use , Humans , Incidence , India/epidemiology , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2
15.
J Nepal Health Res Counc ; 19(2): 414-416, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449550

ABSTRACT

One of the most common complication of Coronavirus disease 2019 (COVID-19) is acute respiratory distress syndrome requiring high flow oxygen, ventilator support, corticosteroids and other supportive therapies. Opportunistic aggressive fungal infection with Mucormycosis, although an uncommon entity otherwise, has been on rise in this pandemic especially in patients with chronic underlying illnesses. One such case of rhino-orbital Mucormycosis in a background of uncontrolled hyperglycaemia presented in the hospital and the histopathological examination of the tissues from ethmoidal sinus and frontal recess showed invasive necro-inflammatory infection by numerous Mucormycosis hyphae. Keywords: COVID-19; mucormycosis; rhino-orbital.


Subject(s)
COVID-19 , Mucormycosis , Hospitals , Humans , Mucormycosis/diagnosis , Mucormycosis/therapy , Nepal , SARS-CoV-2
16.
JNMA J Nepal Med Assoc ; 59(241): 965-967, 2021 Sep 11.
Article in English | MEDLINE | ID: covidwho-1444665

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.


Subject(s)
COVID-19 , Mucormycosis , Humans , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Pandemics , Risk Factors , SARS-CoV-2
17.
Int J Infect Dis ; 112: 278-280, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1442403

ABSTRACT

The second wave of COVID-19 due to the delta variant (B.1.617.2) led to a rapid rise in total coronavirus and COVID-associated mucormycosis cases reported from India. Hence, our study explored the possible causes of a rapid upsurge in COVID-associated mucormycosis, which has accounted for over 70% of global cases. Factors associated with the increase in mucormycosis cases in COVID-19 patients include diabetes mellitus, steroid overdose, high iron levels, and immunosuppression, combined with other possible factors, such as unhygienic conditions, prolonged hospitalization, use of ventilators, and leaky humidifiers in oxygen cylinders. These create an ideal environment for contracting mucormycosis. However, these cases could be reduced by disseminating simple preventive measures and creating awareness among the medical society and general public of this rare and deadly contagion of COVID-associated mucormycosis. The identification of early symptoms will also help to restrict the spread of lethal fungal diseases. Furthermore, a collaborative team of surgeons, ophthalmologists, physicians, and otolaryngologists would be required in the hospital wards to accelerate surgeries on severely impacted patients.


Subject(s)
COVID-19 , Mucormycosis , Disease Outbreaks , Humans , India/epidemiology , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Risk Factors , SARS-CoV-2
18.
Int J Environ Res Public Health ; 18(19)2021 09 30.
Article in English | MEDLINE | ID: covidwho-1444211

ABSTRACT

Mucormycosis, a serious and rare fungal infection, has recently been reported in COVID-19 patients worldwide. This study aims to map all the emerging evidence on the COVID-19-associated mucormycosis (CAM) with a special focus on clinical presentation, treatment modalities, and patient outcomes. An extensive literature search was performed in MEDLINE (Ovid), Embase (Ovid), Cochrane COVID-19 Study Register, and WHO COVID-19 database till 9 June 2021. The primary outcome was to summarize the clinical presentation, treatment modalities, and patient outcomes of CAM. Data were summarized using descriptive statistics and presented in tabular form. This evidence mapping was based on a total of 167 CAM patients with a mean age of 51 ± 14.62 years, and 56.28% of them were male. Diabetes mellitus (73.65% (n = 123)), hypertension (22.75% (n = 38)), and renal failure (10.77% (n = 18)) were the most common co-morbidities among CAM patients. The most common symptoms observed in CAM patients were facial pain, ptosis, proptosis, visual acuity, and vision loss. Survival was higher in patients who underwent both medical and surgical management (64.96%). Overall mortality among CAM patients was found to be 38.32%. In conclusion, this study found a high incidence of CAM with a high mortality rate. Optimal glycemic control and early identification of mucormycosis should be the priority to reduce the morbidity and mortality related to CAM.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , Adult , Aged , Comorbidity , Humans , Male , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2
19.
J Craniofac Surg ; 32(8): e827-e830, 2021.
Article in English | MEDLINE | ID: covidwho-1440702

ABSTRACT

ABSTRACT: Acute invasive fungal rhinosinusitis (mucormycosis) is a rare, highly fatal disease. This opportunistic fungal infection causes angioinvasion and ischemic tissue necrosis. It mainly affects immunocompromised patients. Since the coronavirus disease 2019 (COVID-19) outbreak, many case reports have described the rhino-orbital-cerebral mucormycosis associated with COVID-19. However, the underlying predisposing factors are unknown. Several factors, other than diabetes, which is the most well-known contributing factor, may be involved in causing this severe fungal infection in COVID-19 patients. These factors may include steroid therapy, which is being used in severely dyspneic patients, the use of broad-spectrum antibiotics that may cause fungal flare-ups, and hospitalization with possible nosocomial infections. In addition, increased serum ferritin levels, possible endothelial damage, and pancreatic islets affection among COVID-19 patients may be implicated. Head and neck surgeons should be aware of the increasing prevalence of craniofacial mucormycosis among COVID-19 patients, as early diagnosis and prompt treatment are essential to improve the outcomes.


Subject(s)
COVID-19 , Mucormycosis , Orbital Diseases , Sinusitis , Humans , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2 , Sinusitis/diagnosis , Sinusitis/drug therapy
20.
Acta Biomed ; 92(4): e2021271, 2021 09 02.
Article in English | MEDLINE | ID: covidwho-1395637

ABSTRACT

As the world continues to struggle with the pandemic of COVID-19 (coronavirus disease 2019), several cases of mucormycosis have been reported in these patients with a high mortality rate. We conducted a review of literature and found 19 articles with 20 patients who developed mucormycosis during their COVID-19 infection.14 (70%) were males, and 6(30%) were females. While their mean age was 52.2 ± 17.3, affected men were older than females. Ten (50%) patients also had diabetes. Common clinical findings included ophthalmologic complaints, fever, shortness of breath, and facial pain. Amphotericin B was the most common antifungal used and 40% of cases needed surgical management of the infection. Steroid use was reported in around 12 cases (60%). Unfortunately, the mortality rate was 65% in this group of patients. Several changes in care should be brought for a consistent prevention, early diagnosis, and strong management of mucormycosis in COVID-19 patients.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , Adult , Aged , Antifungal Agents/therapeutic use , Diabetes Mellitus/drug therapy , Female , Humans , Male , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2
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