The association of mucormycosis co-infection in patients with COVID-19 pneumonia: experience at tertiary care hospital in India

Abstract

OBJECTIVE: We performed this study to explore the impact of multiple co-morbidities, different treatment strategies and vaccination in patients diagnosed with mucormycosis co-infection during the ongoing COVID-19 pandemic. PATIENTS AND METHODS: This is an observational study of 60 patients out of 3000 admitted from March 2021 to May 2021 for treatment of COVID-19 pneumonia, with confirmed diagnosis of opportunistic fungal infection. Characteristics like age, antibiotic usage, steroid usage, and associated co-morbidities, need of oxygen or ventilator support and status of vaccination were studied. RESULTS: Out of 60 patients studied, maximum 37 (61.6%) belonged to 40 to 60 years age group and 38 (63.3%) were male. Fifty-two (86.6%) patients had one or other co-morbidities, while 56 (93.3%) of these patients received steroids in oral or intravenous form. Fifty-one (85%) patients received one or more than one higher grade antibiotics during treatment in hospital. Forty-two (70%) patients required Intensive Care Unit (ICU) admission out of which 4 (6.7%) required ventilator support, 10 (16.6%) required Non-Invasive Ventilation (NIV) while 28 (46.6%) were managed with high flow oxygen. CONCLUSIONS: Our observations suggest for judicious use of steroids and higher antibiotics during treatment of COVID-19 pneumonia as it is associated with increased risk of opportunistic fungal infections. Strict control of blood glucose levels, multidisciplinary approach to reduce the impact of opportunistic fungal infection on patient morbidity and widespread vaccination especially among patients with comorbidities will help in mitigating the impact of opportunistic fungal infections in patients with COVID-19 pneumonia.

Keywords

• covid-19
• mucormycosis
• fungal osteomyelitis prevention
• treatment