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COVID19 associated mucormycosis: A review
Priyadharsini R Palanisamy1, Dhivya Elango1
1Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal, Puducherry, India.
Abstract:
Mucormycosis, a rare fungal disease has emerged as a new epidemic in India, during the CoronaVirus Disease 2019 (COVID-19) pandemic. Mucormycosis is caused by the mucormycetes group of molds. Immunocompromised states such as diabetes, chronic steroid use, and patients receiving immunosuppressant drugs are the risk factors for mucormycosis. The second wave of the COVID-19 pandemic has also invited the notorious mucormycosis in the current scenario. India has announced mucormycosis as a notifiable disease in May 2021, as the number of COVID-19-associated mucormycosis cases has increased swiftly. There are different opinions and evidence for the emergence of mucormycosis or the so-called 'black fungus'. It is proposed that the use of steroids, monoclonal antibodies, and prolonged hospitalization in the treatment of COVID-19 has substantially decreased the immunity in COVID-19-affected patients and maybe the reason for the emergence of fungal infections. The other hypothesis is that improper disinfection procedures such as using non-sterile water for humidification of oxygen can be the reason. Or, the COVID-19 infection itself produces an immunocompromised and diabetic-like state is again a question. This review mainly focuses on the discussion and identification of the most common risk factor for mucormycosis, investigations, and management of mucormycosis.
Insights
Mucormycosis, a fungal infection, has become an epidemic in India during the COVID-19 pandemic. This review identifies key risk factors, investigations, and management strategies for this serious condition.
Area of Science:
- Mycology
- Infectious Diseases
- Epidemiology
Background:
- Mucormycosis, a rare fungal infection, has surged as an epidemic in India, coinciding with the COVID-19 pandemic.
- This opportunistic fungal infection is caused by mucormycetes molds and primarily affects immunocompromised individuals.
Purpose of the Study:
- To discuss and identify the most common risk factors associated with mucormycosis.
- To review the investigations and management strategies for mucormycosis.
Main Methods:
- Literature review focusing on COVID-19-associated mucormycosis.
- Analysis of proposed etiological factors and risk profiles.
Main Results:
- Identified risk factors include diabetes, steroid use, immunosuppression, and potentially COVID-19 treatments like steroids and monoclonal antibodies.
- Improper disinfection of medical equipment, such as humidifiers, is also considered a potential contributing factor.
Conclusions:
- The review highlights the multifactorial nature of mucormycosis emergence during the COVID-19 pandemic.
- Understanding risk factors and implementing appropriate investigations and management are crucial for combating this fungal epidemic.
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