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Mucormycosis in COVID-19 patients: predisposing factors, prevention and management.
Rudrabhatla, Pavan Kumar; Reghukumar, Aravind; Thomas, Sanjeev V.
  • Rudrabhatla PK; Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India. pavankumarrudrabhatla@gmail.com.
  • Reghukumar A; Department of Infectious Diseases, Government Medical College, Thiruvananthapuram, India.
  • Thomas SV; Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.
Acta Neurol Belg ; 122(2): 273-280, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1530445
ABSTRACT
India is considered the diabetes capital of the world and has the highest burden of mucormycosis. Bacterial, viral and fungal co-infections are increasingly being reported in severe acute respiratory syndrome virus 2 (SARSCoV-2) infected patients. India is one of the worst affected countries during the second wave of the COVID-19 pandemic. This combination of diabetes mellitus, COVID-19 and mucormycosis has led to the drastic upsurge of COVID-19-associated mucormycosis (CAM) in India. Immunosuppression, iron disequilibrium, endothelial injury, ketoacidosis and hypoxia are some of the other COVID-19-related risk factors for CAM. There has been an increase in the proportion of mucormycosis affecting paranasal sinuses and central nervous system (CNS) in CAM compared to pre-COVID-19 literature due to the SARSCoV-2-related pathophysiological mechanisms, complications and treatment strategies. CAM is a medical and surgical emergency, and it can present with non-specific symptoms and signs initially resulting in diagnostic delay. High index of suspicion and regular screening for features of CAM are of paramount importance to prevent lethal consequences. Rapid action with a tripod approach consisting of withdrawal of immunomodulators, early antifungal therapy and extensive surgical debridement is considered the best possible treatment model. We review the published data to give a detailed account of the predisposing factors and their mechanisms, diagnostic work-up, treatment modalities and prevention strategies of CAM with special emphasis on CNS mucormycosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus / COVID-19 / Mucormycosis Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Acta Neurol Belg Year: 2022 Document Type: Article Affiliation country: S13760-021-01840-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus / COVID-19 / Mucormycosis Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Acta Neurol Belg Year: 2022 Document Type: Article Affiliation country: S13760-021-01840-w