Mucormycosis and COVID-19: A systemic review

Abstract

COVID-19 presents severely in persons with immunocompromised states such as diabetes mellitus. Steroids are used in the management of COVID-19. The use of steroids in immunocompromised persons increases the chances of opportunistic infections. Mucormycosis infects immunocompromised individuals. The aim of this systemic review was to study the clinico-epidemiological features of mucormycosis in patients of COVID-19. PubMed, Medline, Embase, and Google Scholar were searched for “mucormycosis”, “COVID-19”, and “SARS-Cov 2”. A total of 30 studies were included in this study, which included 22 case reports and 8 original articles. The median age of patients was 54.80 years; 79.56% (74/93) were diabetic. Steroid administration history was present in 74.19% (69/93) of patients. Rhino-orbital mucormycosis constituted 46.98% (39/83) of the cases, rhino-orbital-cerebral type in 37.35% (31/83) cases, pulmonary mucormycosis in 10.84% (9/83) cases, 1 case of gastric mucormycosis, 1 case of cutaneous mucormycosis, 1 case of palatal mucormycosis, and 1 case of disseminated mucormycosis. The median duration of presentation of mucormycosis was 14 days after hospital admission. The total number of deaths was reported in 32.26% (30/93) of the cases. The most common species found was Rhizopus, and amphotericin B was the most common antifungal administered. The COVID-19 pandemic is creating a massive pool of susceptible patients having poorly controlled diabetes mellitus and receiving steroids for COVID-19 management, thus creating an unholy alliance with mucormycosis. Mucormycosis started as a new epidemic in India, which is an otherwise rare opportunistic fungal infection.

Keywords

• covid-19
• mucormycosis
• sars-cov2