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Aspergillosis and Mucormycosis in COVID-19 Patients: A Systematic Review
1Community Medicine, King Edward Medical University, Lahore, Pakistan.
Abstract:
Fungal infections have increased in number since the onset of this lethal pandemic. This study aimed to assess risk factors and case fatality in COVID-19 cases with aspergillosis or mucormycosis. A systematic review was done according to PRISMA guidelines. Databases used were Google scholar, Pakmedinet, PUBMED, and MEDLINE. Twenty-one case reports and case series of mucormycosis in COVID-19 patients were identified and the mean age was 56.3 years (36 men and 12 women). The most common comorbidity was diabetes and the site was rhino orbital mucormycosis. Case fatality of 48 combined cases was calculated to be 52%. Nineteen articles of aspergillosis were included. Diabetes was the most common comorbidity in cases. The number of affected men cases was more than women. The incidence of aspergillosis in critically sick COVID-19 patients was calculated to be 9.3%. Case fatality was calculated to be 51.2%. Screening can be a beneficial tool for decreasing morbidity and mortality. Key Words: COVID-19, Mucormycosis, Aspergillosis.
Insights
Fungal infections like mucormycosis and aspergillosis are rising in COVID-19 patients. This review found high fatality rates, emphasizing the need for early screening to reduce deaths.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Public Health
Background:
- The COVID-19 pandemic has seen a concerning rise in invasive fungal infections.
- Mucormycosis and aspergillosis are serious opportunistic infections observed in COVID-19 patients.
- Understanding risk factors and outcomes is crucial for managing these co-infections.
Purpose of the Study:
- To assess risk factors associated with mucormycosis and aspergillosis in COVID-19 patients.
- To determine the case fatality rates for these fungal infections in the context of COVID-19.
- To evaluate the potential benefit of screening for fungal infections in critically ill COVID-19 patients.
Main Methods:
- A systematic review was conducted following PRISMA guidelines.
- Databases searched included Google Scholar, Pakmedinet, PubMed, and MEDLINE.
- Data were extracted from case reports and case series of COVID-19 patients with mucormycosis or aspergillosis.
Main Results:
- Twenty-one studies on mucormycosis identified a mean patient age of 56.3 years, with diabetes as the most common comorbidity and rhino-orbital being the primary site. Case fatality was 52%.
- Nineteen articles on aspergillosis reported diabetes as a frequent comorbidity. The incidence in critically ill COVID-19 patients was 9.3%, with a case fatality of 51.2%.
- Men were more frequently affected than women in both fungal infection groups.
Conclusions:
- COVID-19 patients, particularly those with diabetes, face significant risks of mucormycosis and aspergillosis.
- These fungal infections carry high case fatality rates, underscoring their severity.
- Implementing screening protocols for fungal infections in critically ill COVID-19 patients may reduce morbidity and mortality.
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