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COVID-19 associated mucormycosis (CAM) in India: a formidable challenge
Vishal U S Rao1, Gururaj Arakeri2, Gaurav Madikeri3
1COVID Task Force & Sub-Committee on Mucormycosis, Government of Karnataka, India; Department of Head and Neck Oncology, Centre for Academic Research, HCG Cancer Center, Bengaluru, Karnataka, India.
Abstract:
Together with the ongoing serious COVID-19 second wave in India, a serious fungal infection, mucormycosis has been increasingly found in COVID-19-recovered patients. Colloquially known as 'black fungus', mucormycosis commonly causes necrosis in the head and neck including the nose, paranasal sinuses, orbits, and facial bones, with possible intracranial spread. The disease causes high morbidity and mortality given that it progresses rapidly and diagnosis is often delayed. Given the sheer magnitude of the outbreak, the Indian Health Ministry has advised all states to declare mucormycosis an epidemic. Typically, the disease has been found to be linked to COVID-19 infections caused by the B.1.617.2 (Delta) variant, which has spread rapidly throughout the country. This variant has already become a cause for global concern, having spread to at least 40 countries, including the USA and UK. We present the findings of a study conducted on COVID-19 associated mucormycosis (CAM) patients, and discuss the associated risk factors to raise awareness for OMFS colleagues.
Insights
A serious fungal infection, mucormycosis (black fungus), is increasingly found in COVID-19 survivors in India. This study highlights risk factors for COVID-19 associated mucormycosis (CAM) to increase awareness among medical professionals.
Area of Science:
- Infectious Diseases
- Ophthalmology
- Oral and Maxillofacial Surgery
Background:
- A severe second wave of COVID-19 in India has been accompanied by a rise in mucormycosis cases among recovered patients.
- Mucormycosis, or 'black fungus,' is a serious infection causing necrosis in the head and neck, with potential for intracranial spread.
- The B.1.617.2 (Delta) COVID-19 variant is frequently associated with these mucormycosis cases, raising global health concerns.
Purpose of the Study:
- To present findings on COVID-19 associated mucormycosis (CAM) patients.
- To discuss risk factors associated with CAM.
- To raise awareness of CAM among Oral and Maxillofacial Surgery (OMFS) professionals.
Main Methods:
- Retrospective analysis of CAM patient cases.
- Identification and discussion of clinical risk factors.
- Literature review on mucormycosis and COVID-19 association.
Main Results:
- CAM presents with high morbidity and mortality due to rapid progression and delayed diagnosis.
- The B.1.617.2 (Delta) variant of SARS-CoV-2 is a significant factor in CAM outbreaks.
- Specific risk factors contributing to CAM development in COVID-19 patients were identified.
Conclusions:
- COVID-19 associated mucormycosis is a significant public health threat, particularly during the Delta variant surge.
- Early diagnosis and awareness of risk factors are crucial for managing CAM.
- OMFS specialists play a vital role in the multidisciplinary management of CAM.
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