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Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India

Samir Joshi, Rahul Telang, Muralidhar Tambe

    Emerging Infectious Diseases
    |September 29, 2021
    PubMed

    Insights

    Mucormycosis, a fungal infection, surged during COVID-19, particularly in diabetic patients treated with steroids. Early diagnosis and surgical intervention are crucial for managing this severe rhino-orbital-cerebral disease.

    Area of Science:

    • Infectious Diseases
    • Ophthalmology
    • Otolaryngology
    • Neurosurgery

    Background:

    • The coronavirus disease (COVID-19) pandemic has been associated with a rise in mucormycosis cases.
    • Mucormycosis, a serious fungal infection, poses a significant threat, especially in immunocompromised individuals.

    Purpose of the Study:

    • To investigate the epidemiology and clinical characteristics of mucormycosis in patients following COVID-19 treatment.
    • To identify risk factors and outcomes associated with rhino-sino-orbital and cerebral mucormycosis during the pandemic.

    Main Methods:

    • Retrospective chart review of 178 patients with confirmed mucormycosis post-COVID-19 treatment.
    • Data collection included patient demographics, COVID-19 severity, comorbidities, treatment, clinical presentation, and outcomes.

    Main Results:

    • The median time from COVID-19 detection to symptom onset was 28 days.
    • 73% of patients had moderate to severe COVID-19, and 74.2% had diabetes; 52.8% received steroids.
    • Nasal eschar was present in 75%, bone penetration in ~90%, and multifocal disease in 60%. Mortality was 15%, with 62% of deaths occurring in multifocal cases.

    Conclusions:

    • Mucormycosis is a significant complication in COVID-19 patients, particularly those with diabetes and steroid use.
    • Aggressive surgical debridement is essential, and multifocal disease portends a poor prognosis.
    Keywords:
    COVID-19IndiaSARS-CoV-2coronavirus disease 2019fungal infectionsfungiinvasive mucormycosisrespiratory infectionsrhino-sino-orbital mucormycosissevere acute respiratory syndrome coronavirus 2viruseszoonoses

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