Aspergillosis and Mucormycosis in COVID-19 Patients: A Systematic Review

Saira Afzal1, Mehreen Nasir1

  • 1Community Medicine, King Edward Medical University, Lahore, Pakistan.

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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