Skip to main content
Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery 4/2023

10.06.2023 | Original Article

COVID-19 Associated Mucormycosis

verfasst von: Sana Tazeem, A. Nagaraju, Hazeera Begum, Joshi Anto Tommi, L. Sudarshan Reddy, M. Vijay Kumar

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Ausgabe 4/2023

Einloggen, um Zugang zu erhalten

Abstract

Mucormycosis is a life-threatening opportunistic fungal infection seen in immunocompromised states. Rising incidence of mucormycosis among Coronavirus Disease-2019 infected individuals is an increasing concern in India. The disease which was endemic has blown out to become an epidemic. The purpose of this research is to study the epidemiology, management and outcome of Coronavirus Disease-2019 Associated Mucormycosis (CAM) cases. Additionally, the role of diabetes and steroids in the causation of CAM was determined. A hospital-based observational study was conducted at a tertiary care centre involving cases with rhino-orbital mucormycosis with recent history of COVID-19 infection. Out of 205,166(81%) cases had Diabetes Mellitus as a comorbid condition. Among them, 75(36.6%) cases were diagnosed with diabetes during COVID-19 treatment. 161/205(78.5%) cases received corticosteroids during COVID-19 treatment. Corticosteroids were notindicated in 43(26.7%) cases. 177/205(85.4%) cases were alive at the end of 12 weeks. 8 out of 10 deaths were seen in cases having diabetes. As the incidence of mucormycosis is increasing, better awareness among general population about the disease, early diagnosis and multidisciplinary approach is required to improve prognosis.
Literatur
2.
Zurück zum Zitat Ripa M, Galli L, Poli A, Oltolini C, Spagnuolo V, Mastrangelo A et al (2021) COVID-19-BioB study group. Secondary infections in cases hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect 27:451–457CrossRefPubMed Ripa M, Galli L, Poli A, Oltolini C, Spagnuolo V, Mastrangelo A et al (2021) COVID-19-BioB study group. Secondary infections in cases hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect 27:451–457CrossRefPubMed
3.
Zurück zum Zitat Song G, Liang G, Liu W (2020) Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia 185(4):599–606CrossRefPubMedPubMedCentral Song G, Liang G, Liu W (2020) Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia 185(4):599–606CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Camara-Lemarroy CR, González-Moreno EI, Rodríguez-Gutiérrez R, Rendón-Ramírez EJ, Ayala-Cortés AS, Fraga-Hernández ML, García-Labastida L, Galarza-Delgado DÁ (2014) Clinical features and outcome of mucormycosis. Interdiscip Perspect Infect Dis 2014:562610CrossRefPubMedPubMedCentral Camara-Lemarroy CR, González-Moreno EI, Rodríguez-Gutiérrez R, Rendón-Ramírez EJ, Ayala-Cortés AS, Fraga-Hernández ML, García-Labastida L, Galarza-Delgado DÁ (2014) Clinical features and outcome of mucormycosis. Interdiscip Perspect Infect Dis 2014:562610CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, Bhalla A, Puri GD, Chakrabarti A, Agarwal R (2021) Coronavirus disease (COVID-19) associated mucormycosis (CAM): case report and systematic review of literature. Mycopathologia 186(2):289–298CrossRefPubMedPubMedCentral Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, Bhalla A, Puri GD, Chakrabarti A, Agarwal R (2021) Coronavirus disease (COVID-19) associated mucormycosis (CAM): case report and systematic review of literature. Mycopathologia 186(2):289–298CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Venkatesh D, Dandagi S, Chandrappa PR, Hema KN (2018) Mucormycosis in immunocompetent patient resulting in extensive maxillary sequestration. J Oral Maxillofac Pathol 22(Suppl 1):S112–S116CrossRefPubMedPubMedCentral Venkatesh D, Dandagi S, Chandrappa PR, Hema KN (2018) Mucormycosis in immunocompetent patient resulting in extensive maxillary sequestration. J Oral Maxillofac Pathol 22(Suppl 1):S112–S116CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Patel A, Agarwal R, Rudramurthy SM et al (2021) Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India. Emerg Infect Dis 27:2349CrossRefPubMedPubMedCentral Patel A, Agarwal R, Rudramurthy SM et al (2021) Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India. Emerg Infect Dis 27:2349CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Bayram N, Ozsaygılı C, Sav H, Tekin Y, Gundogan M, Pangal E, Cicek A, Özcan İ (2021) Susceptibility of severe COVID-19 cases to rhino-orbital mucormycosis fungal infection in different clinical manifestations. Jpn J Ophthalmol 65(4):515–525CrossRefPubMedPubMedCentral Bayram N, Ozsaygılı C, Sav H, Tekin Y, Gundogan M, Pangal E, Cicek A, Özcan İ (2021) Susceptibility of severe COVID-19 cases to rhino-orbital mucormycosis fungal infection in different clinical manifestations. Jpn J Ophthalmol 65(4):515–525CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat India reported over 45000 cases so far (2021) Hindustan Times India reported over 45000 cases so far (2021) Hindustan Times
11.
12.
Zurück zum Zitat Skiada A, Pavleas I, Drogari-Apiranthitou M (2020) Epidemiology and diagnosis of mucormycosis: an update. J Fungi (Basel) 6(4):265CrossRefPubMed Skiada A, Pavleas I, Drogari-Apiranthitou M (2020) Epidemiology and diagnosis of mucormycosis: an update. J Fungi (Basel) 6(4):265CrossRefPubMed
13.
Zurück zum Zitat Pandey SK, Sharma V (2018) World diabetes day 2018: battling the emerging epidemic of diabetic retinopathy. Indian J Ophthalmol 66(11):1652–1653CrossRefPubMedPubMedCentral Pandey SK, Sharma V (2018) World diabetes day 2018: battling the emerging epidemic of diabetic retinopathy. Indian J Ophthalmol 66(11):1652–1653CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Morales-Franco B, Nava-Villalba M, Medina-Guerrero EO, Sánchez-Nuño YA, Davila-Villa P, Anaya-Ambriz EJ, Charles-Niño CL (2021) Host-pathogen molecular factors contribute to the pathogenesis of Rhizopus spp. in diabetes mellitus. Curr Trop Med Rep. 8:1–12CrossRef Morales-Franco B, Nava-Villalba M, Medina-Guerrero EO, Sánchez-Nuño YA, Davila-Villa P, Anaya-Ambriz EJ, Charles-Niño CL (2021) Host-pathogen molecular factors contribute to the pathogenesis of Rhizopus spp. in diabetes mellitus. Curr Trop Med Rep. 8:1–12CrossRef
16.
Zurück zum Zitat Bayram N, Ozsaygılı C, Sav H et al (2021) Susceptibility of severe COVID-19 cases to rhino-orbital mucormycosis fungal infection in different clinical manifestations. Jpn J Ophthalmol 65(4):515–525CrossRefPubMedPubMedCentral Bayram N, Ozsaygılı C, Sav H et al (2021) Susceptibility of severe COVID-19 cases to rhino-orbital mucormycosis fungal infection in different clinical manifestations. Jpn J Ophthalmol 65(4):515–525CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Bala K, Chander J, Handa U, Punia RS, Attri AK (2015) A prospective study of mucormycosis in north India: experience from a tertiary care hospital. Med Mycol 53(3):248–257CrossRefPubMed Bala K, Chander J, Handa U, Punia RS, Attri AK (2015) A prospective study of mucormycosis in north India: experience from a tertiary care hospital. Med Mycol 53(3):248–257CrossRefPubMed
18.
Zurück zum Zitat Garg R, Bharangar S, Gupta S, Bhardwaj S (2021) Post COVID-19 infection presenting as rhino-orbital mycosis. Indian J Otolaryngol Head Neck Surg 14:1–8 Garg R, Bharangar S, Gupta S, Bhardwaj S (2021) Post COVID-19 infection presenting as rhino-orbital mycosis. Indian J Otolaryngol Head Neck Surg 14:1–8
19.
Zurück zum Zitat Badiee P, Arastefar A, Jafarian H (2013) Comparison of histopathological analysis, culture and polymerase chain reaction assays to detect mucormycosis in biopsy and blood specimens. Iran J Microbiol 5(4):406–410PubMedPubMedCentral Badiee P, Arastefar A, Jafarian H (2013) Comparison of histopathological analysis, culture and polymerase chain reaction assays to detect mucormycosis in biopsy and blood specimens. Iran J Microbiol 5(4):406–410PubMedPubMedCentral
20.
22.
Zurück zum Zitat Honavar SG (2021) Code mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian J Ophthalmol 69(6):1361–1365CrossRefPubMedPubMedCentral Honavar SG (2021) Code mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian J Ophthalmol 69(6):1361–1365CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Malhotra HS, Gupta P, Mehrotra D et al (2021) COVID-19 associated mucormycosis: staging and management recommendations (Report of a multi-disciplinary expert committee). J Oral Biol Craniofac Res 11(4):569–580CrossRefPubMedPubMedCentral Malhotra HS, Gupta P, Mehrotra D et al (2021) COVID-19 associated mucormycosis: staging and management recommendations (Report of a multi-disciplinary expert committee). J Oral Biol Craniofac Res 11(4):569–580CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Spellberg B, Edwards J Jr, Ibrahim A (2005) Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 18(3):556–569CrossRefPubMedPubMedCentral Spellberg B, Edwards J Jr, Ibrahim A (2005) Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 18(3):556–569CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Moorthy A, Gaikwad R, Krishna S et al (2021) SARS-CoV-2, uncontrolled diabetes and corticosteroids-an unholy trinity in invasive fungal infections of the maxillofacial region? A retrospective, multi-centric analysis. J Maxillofac Oral Surg. 20(3):1–8CrossRef Moorthy A, Gaikwad R, Krishna S et al (2021) SARS-CoV-2, uncontrolled diabetes and corticosteroids-an unholy trinity in invasive fungal infections of the maxillofacial region? A retrospective, multi-centric analysis. J Maxillofac Oral Surg. 20(3):1–8CrossRef
26.
Zurück zum Zitat Papachristou S, Stamatiou I, Stoian AP, Papanas N (2021) New-Onset diabetes in COVID-19: time to frame its fearful symmetry. Diabetes Ther 12(2):461–464CrossRefPubMed Papachristou S, Stamatiou I, Stoian AP, Papanas N (2021) New-Onset diabetes in COVID-19: time to frame its fearful symmetry. Diabetes Ther 12(2):461–464CrossRefPubMed
27.
Zurück zum Zitat Müller JA, Groß R, Conzelmann C et al (2021) SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas. Nat Metab 3(2):149–165CrossRefPubMed Müller JA, Groß R, Conzelmann C et al (2021) SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas. Nat Metab 3(2):149–165CrossRefPubMed
28.
30.
Zurück zum Zitat Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, Liu L, Shan H, Lei C-L, Hui DS (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382:1708–1720CrossRefPubMed Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, Liu L, Shan H, Lei C-L, Hui DS (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382:1708–1720CrossRefPubMed
31.
Zurück zum Zitat Tang Y, Liu J, Zhang D, Xu Z, Ji J, Wen C (2020) Cytokine storm in COVID-19: the current evidence and treatment strategies. Front Immunol 10(11):1708CrossRef Tang Y, Liu J, Zhang D, Xu Z, Ji J, Wen C (2020) Cytokine storm in COVID-19: the current evidence and treatment strategies. Front Immunol 10(11):1708CrossRef
32.
Zurück zum Zitat Bhaskar S, Sinha A, Banach M, Mittoo S, Weissert R, Kass JS, Rajagopal S, Pai AR, Kutty S (2020) Cytokine storm in COVID-19-immunopathological mechanisms, clinical considerations, and therapeutic approaches: the REPROGRAM consortium position paper. Front Immunol 10(11):1648CrossRef Bhaskar S, Sinha A, Banach M, Mittoo S, Weissert R, Kass JS, Rajagopal S, Pai AR, Kutty S (2020) Cytokine storm in COVID-19-immunopathological mechanisms, clinical considerations, and therapeutic approaches: the REPROGRAM consortium position paper. Front Immunol 10(11):1648CrossRef
33.
Zurück zum Zitat Mahmud-Al-Rafat A, Majumder A, Taufiqur Rahman KM et al (2019) Decoding the enigma of antiviral crisis: does one target molecule regulate all? Cytokine 115:13–23CrossRefPubMedPubMedCentral Mahmud-Al-Rafat A, Majumder A, Taufiqur Rahman KM et al (2019) Decoding the enigma of antiviral crisis: does one target molecule regulate all? Cytokine 115:13–23CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Fathi N, Rezaei N (2020) Lymphopenia in COVID-19: therapeutic opportunities. Cell Biiol Int 44(9):1792–1797CrossRef Fathi N, Rezaei N (2020) Lymphopenia in COVID-19: therapeutic opportunities. Cell Biiol Int 44(9):1792–1797CrossRef
35.
Zurück zum Zitat Cai J, Li H, Zhang C et al (2021) The neutrophil-to-lymphocyte ratio determines clinical efficacy of corticosteroid therapy in cases with COVID-19. Cell Metab 33(2):258-269.e3CrossRefPubMedPubMedCentral Cai J, Li H, Zhang C et al (2021) The neutrophil-to-lymphocyte ratio determines clinical efficacy of corticosteroid therapy in cases with COVID-19. Cell Metab 33(2):258-269.e3CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J Jr, Ibrahim AS (2009) Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 48(12):1743–1751CrossRefPubMed Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J Jr, Ibrahim AS (2009) Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 48(12):1743–1751CrossRefPubMed
38.
Zurück zum Zitat Nithyanandam S, Jacob MS, Battu RR, Thomas RK, Correa MA, D’Souza O (2003) Rhino-orbito-cerebral mucormycosis. A retrospective analysis of clinical features and treatment outcomes. Indian J Ophthalmol 51(3):231–236PubMed Nithyanandam S, Jacob MS, Battu RR, Thomas RK, Correa MA, D’Souza O (2003) Rhino-orbito-cerebral mucormycosis. A retrospective analysis of clinical features and treatment outcomes. Indian J Ophthalmol 51(3):231–236PubMed
39.
Zurück zum Zitat Pelton RW, Peterson EA, Patel BC, Davis K (2001) Successful treatment of rhino-orbital mucormycosis without exenteration: the use of multiple treatment modalities. Ophthalmic Plast Reconstr Surg 17(1):62–66CrossRefPubMed Pelton RW, Peterson EA, Patel BC, Davis K (2001) Successful treatment of rhino-orbital mucormycosis without exenteration: the use of multiple treatment modalities. Ophthalmic Plast Reconstr Surg 17(1):62–66CrossRefPubMed
40.
Zurück zum Zitat Sen M, Honavar SG, Bansal R, Sengupta S et al (2021) Epidemiology, clinical profile, management and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 cases in India—collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1. Indian J Ophthalmol 69(7):1670–1692CrossRefPubMedPubMedCentral Sen M, Honavar SG, Bansal R, Sengupta S et al (2021) Epidemiology, clinical profile, management and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 cases in India—collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1. Indian J Ophthalmol 69(7):1670–1692CrossRefPubMedPubMedCentral
Metadaten
Titel
COVID-19 Associated Mucormycosis
verfasst von
Sana Tazeem
A. Nagaraju
Hazeera Begum
Joshi Anto Tommi
L. Sudarshan Reddy
M. Vijay Kumar
Publikationsdatum
10.06.2023
Verlag
Springer India
Erschienen in
Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe 4/2023
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-023-03676-7

Weitere Artikel der Ausgabe 4/2023

Indian Journal of Otolaryngology and Head & Neck Surgery 4/2023 Zur Ausgabe

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.