Related Experiment Video
Updated: Jul 12, 2025
An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
Risk Factors, Clinical Manifestations, and Outcomes of COVID-19-Associated Mucormycosis and Other Opportunistic
Dinesh Kumar1, Faiz Ahmad1, Anil Kumar2
1Otolaryngology, Maharaja Agrasen Medical College, Agroha, IND.
Introduction:
An epidemic of opportunistic fungal infections during the second wave of the coronavirus disease 2019 (COVID-19) pandemic badly affected India in 2021. Several unknown, unique factors played a role in its causation and survival outcomes, including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of this study was to analyse the probable underlying risk factors and to know immediate and late outcomes of opportunistic fungal infections in the unique setting of the SARS-CoV-2 pandemic.
Methods:
In this retrospective cohort study, clinical records of COVID-19-associated opportunistic fungal infections were reviewed for risk factors, clinical features, microbiological and pathological findings, and outcomes during a one-year follow-up at a tertiary care teaching hospital in Northern India.
Results:
A total of 390 patients were admitted with symptoms and clinical signs consistent with the criteria for the diagnosis of COVID-19-associated mucormycosis (CAM). Diabetes mellitus was the most common comorbidity (74%). During the management of SARS-CoV-2, 192 (49%) patients received corticosteroids, 151 (39%) were on oxygen support, and 143 (37%) used at-home steam inhalation. Masks of any type were used by 236 (60.5%) patients, of whom most used cloth masks (n=147, 37.6%). Microbiologically, fungal growth was positive in 138 (35.3%) samples; of these, 74 (19%) had non-Mucorales fungal colonies. The fungal infection invaded structures beyond the paranasal sinuses in 60% of the cases. The overall mortality in this cohort after one-year follow-up was 40.25%.
Conclusions:
An alignment of several predisposing conditions precipitated an epidemic of opportunistic fungal infections during the COVID-19 pandemic that resulted in high mortality in affected patients.
Insights
Opportunistic fungal infections, particularly COVID-19-associated mucormycosis, surged during the pandemic in India. This epidemic led to high mortality, driven by factors like diabetes and corticosteroid use.
Area of Science:
- Infectious Diseases
- Epidemiology
- Mycology
Background:
- The COVID-19 pandemic's second wave in India (2021) saw an epidemic of opportunistic fungal infections.
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was linked to increased risk and poor outcomes.
- Unique factors contributing to this epidemic remain under investigation.
Purpose of the Study:
- To analyze risk factors for opportunistic fungal infections during the SARS-CoV-2 pandemic.
- To investigate the immediate and late outcomes of these infections in the pandemic context.
Main Methods:
- Retrospective cohort study of COVID-19-associated opportunistic fungal infections.
- Review of clinical records for risk factors, clinical features, microbiology, pathology, and outcomes.
- One-year follow-up at a tertiary care hospital in Northern India.
Main Results:
- 390 patients diagnosed with COVID-19-associated mucormycosis (CAM); diabetes mellitus was the most common comorbidity (74%).
- Corticosteroid use (49%), oxygen support (39%), and home steam inhalation (37%) were frequent during SARS-CoV-2 management.
- Overall one-year mortality was high at 40.25%.
Conclusions:
- A confluence of predisposing conditions fueled the opportunistic fungal infection epidemic during the COVID-19 pandemic.
- The epidemic resulted in significant mortality among affected patients.
- Understanding these factors is crucial for managing future outbreaks.
Related Concept Videos
01:29Fungal Group Zygomycota
01:23Skin Diseases and Disorders
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
01:28Fungal Phylum Microsporidia
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:29Overview of Fungi