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Case Reports
. 2021 Nov-Dec:44:102148.
doi: 10.1016/j.tmaid.2021.102148. Epub 2021 Aug 26.

COVID-19-associated mucormycosis: Case report and systematic review

Ahmet Dilek  1 , Resat Ozaras  2 , Sevket Ozkaya  3 , Mustafa Sunbul  4 , Elif Itir Sen  5 , Hakan Leblebicioglu  6
Affiliations
Case Reports

COVID-19-associated mucormycosis: Case report and systematic review

Ahmet Dilek et al. Travel Med Infect Dis. 2021 Nov-Dec.

Abstract

Background: Increasing number of patients with COVID-19-associated mucormycosis have been reported, especially from India recently. We have described a patient with COVID-19-associated mucormycosis and, searched and analyzed current medical literature to delineate the characteristics of COVID-19-associated mucormycosis.

Method: We reported a patient developed mucormycosis during post-COVID period. We searched literature to describe the incidence, clinical features, and outcomes of COVID-19-associated mucormycosis. Demographic features, risk factors, clinical features, diagnostic methods, treatment and outcome were analyzed.

Results: We describe a 54-year-old male, hospitalized due to severe COVID-19 pneumonia. He was given long-term, high doses of systemic steroids. He developed maxillo-fascial mucormycosis and died of sepsis. Our literature search found 30 publications describing 100 patients including present case report. The majority (n = 68) were reported from India. 76% were male. The most commonly seen risk factors were corticosteroid use (90.5%), diabetes (79%), and hypertension (34%). Also, excessive use of broad-spectrum antibiotics were noted in cases. Most frequent involvements were rhino-orbital (50%), followed by rhino-sinusal (17%), and rhino-orbito-cerebral (15%). Death was reported as 33 out of 99 patients (33,3%).

Conclusions: Steroid use, diabetes, environmental conditions, excessive use of antibiotics, and hypoxia are main risk factors. Despite medical and surgical treatment, mortality rate is high. A multidisciplinary approach is essential to improve the conditions facilitating the emergence of COVID-19-associated mucormycosis.

Keywords: COVID-19; Coronavirus; Fungal infections; Mucor; Mucormycosis.

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Figures

Fig. 1
Fig. 1
Review process of medical literature about COVID-19 and mucormycosis.
Fig. 2
Fig. 2
Chest roentgenography is showing as normal but HRCT images showing the fibrotic changes after the COVID 19 infection.
Fig. 3
Fig. 3
Cranial MRI images showing the irregular opacities in the right maxillary sinus (arrows) and just adjacent to orbital & oral cavity which consisted with mucormycosis.
See this image and copyright information in PMC

Comment in

  • COVID-19 and mucormycosis in Latin America - An emerging concern.
    Rodriguez-Morales AJ, Mamani-García CS, Nuñez-Lupaca JN, León-Figueroa DA, Olarte-Durand M, Yrene-Cubas RA, Ticona DM, Abanto-Urbano S. Rodriguez-Morales AJ, et al. Travel Med Infect Dis. 2021 Nov-Dec;44:102156. doi: 10.1016/j.tmaid.2021.102156. Epub 2021 Aug 25. Travel Med Infect Dis. 2021. PMID: 34454089 Free PMC article. No abstract available.

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