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Review
. 2021 Oct;49(5):833-853.
doi: 10.1007/s15010-021-01670-1. Epub 2021 Jul 24.

COVID-19 and mucormycosis superinfection: the perfect storm

Jaffar A Al-Tawfiq  1   2   3   4 , Saad Alhumaid  5 , Abeer N Alshukairi  6 , Mohamad-Hani Temsah  7 , Mazin Barry  8 , Abbas Al Mutair  9   10   11 , Ali A Rabaan  12 , Awadh Al-Omari  13   14 , Raghavendra Tirupathi  15   16 , Manaf AlQahtani  17   18   19 , Salma AlBahrani  20 , Kuldeep Dhama  21
Affiliations
Review

COVID-19 and mucormycosis superinfection: the perfect storm

Jaffar A Al-Tawfiq et al. Infection. 2021 Oct.

Abstract

Background: The recent emergence of the Coronavirus Disease (COVID-19) disease had been associated with reports of fungal infections such as aspergillosis and mucormycosis especially among critically ill patients treated with steroids. The recent surge in cases of COVID-19 in India during the second wave of the pandemic had been associated with increased reporting of invasive mucormycosis post COVID-19. There are multiple case reports and case series describing mucormycosis in COVID-19.

Purpose: In this review, we included most recent reported case reports and case-series of mucormycosis among patients with COVID-19 and describe the clinical features and outcome.

Results: Many of the mucormycosis reports were eported from India, especially in COVID-19 patients who were treated and recovered patients. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis. Those patients were diabetic and had corticosteroids therapy for controlling the severity of COVID-19, leading to a higher fatality in such cases and complicating the pandemic scenario. The triad of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), corticosteroid use and uncontrolled diabetes mellitus have been evident for significant increase in the incidence of angioinvasive maxillofacial mucormycosis. In addition, the presence of spores and other factors might play a role as well.

Conclusion: With the ongoing COVID-19 pandemic and increasing number of critically ill patients infected with SARS-CoV-2, it is important to develop a risk-based approach for patients at risk of mucormycosis based on the epidemiological burden of mucormycosis, prevalence of diabetes mellitus, COVID-19 disease severity and use of immune modulating agents including the combined use of corticosteroids and immunosuppressive agents in patients with cancer and transplants.

Keywords: COVID-19; Mucormycosis; SARS-CoV-2.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Possible contributing Factors for the development of Mucormycosis among COVID-19 patients
See this image and copyright information in PMC

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