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Review
. 2021 Apr 15;7(4):298.
doi: 10.3390/jof7040298.

When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

Teny M John  1 , Ceena N Jacob  2 , Dimitrios P Kontoyiannis  1
Affiliations
Review

When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

Teny M John et al. J Fungi (Basel). .

Abstract

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.

Keywords: COVID-19; diabetes mellitus; mucormycosis.

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Conflict of interest statement

D.P.K. reports honoraria, research support from Gilead Sciences; consultant fees from Astellas Pharma and Mayne, Inc. and he is a member of the Data Review Committee of Cidara Therapeutics. TMJ, CNJ: none

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