COVID‐19–associated mucormycosis, diabetes and steroid therapy: Experience in a single centre in Western Mexico

Abstract

Background COVID‐19–associated mucormycosis (CAM) has emerged as a challenging complication as the current pandemic has increased the population requiring treatment with corticosteroids. CAM has caused a massive outbreak in India, reported to be causing cases in Iran, Egypt and The Netherlands. Objectives To describe CAM cases occurring in a single centre in Western Mexico. Methods Our group carried out a retrospective study from May 2020 to May 2021 to identify CAM cases in patients with previous COVID‐19 diagnosis. Results Six CAM cases occurred in a single centre in Western Mexico during the study period, most of them with diabetes (n = 5/6) and all received corticosteroid therapy even when only three had severe COVID‐19. After analysing local COVID‐19 burden, it was estimated that in this region, CAM was 300 times more frequent among COVID individuals than the estimates for general population. Conclusion Similar to large reports in India and other countries, CAM cases reported in this study were diagnosed in individuals with diabetes, hyperglycaemic status and with history of previous use of corticosteroids. Identifying these individuals at risk can help the early identification of CAM. In addition, strict glycaemic control and avoidance of unnecessary corticosteroid in non‐severe COVID‐19 cases could help in preventing this complicated fungal infection.

Definition, diagnosis, and management of COVID-19-associated pulmonary mucormycosis: Delphi consensus statement from the Fungal Infection Study Forum and Academy of Pulmonary Sciences, India

“…The prevalence of CAPM was reported to be 0·01% in patients with COVID-19 from the community (data from one centre in Mexico), 0·15% in patients admitted to hospital with COVID-19 (data from five tertiary-care centres in India), and 1·00% in patients with COVID-19 on mechanical ventilation (data from 59 micology laboratories in France). 6 , 12 , 13 The burden of CAPM following the second wave of the COVID-19 pandemic in India and other countries remains largely unknown. 14 , 15 , 16 , 17 …”

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

“…[ 47 ] India Retrospective Single-center 11 Feb 2020–May 2021 47 ± 11 100 (11) 64 (7) Fouad YA. [ 48 ] Egypt Retrospective Single-center 26 Apr 2021–Aug 2021 63 [46–70] 54 (14) 96 (25) Meher R. [ 49 ] Iran Prospective Single-center 111 May 2021–Jun 2021 53 ± 12 70 (78) 94 (104) Guzman-Castro S. [ 50 ] UK Retrospective Single-center 6 May 2021 52 [45–57] 83 (5) 83 (5) Kumar H. [ 51 ] India Retrospective Single-center 28 Apr 2021–May 2021 54 [48–59] 79 (22) 75 (21) Yadav T. [ 52 ] India Retrospective Single-center 50 Dec 2020–Jun 2021 50 [28–70] 62 (31) 86 (43) Meshram HS. [ 53 ] India Retrospective …”

“…[ 47 ] 45 (5) 100 (11) 100 (11) – 36 (4) 0 (0) 36 (4) – Fouad YA. [ 48 ] 27 (7) 12 (3) – – – – 77 (20) – Meher R. [ 49 ] – – – – 27 (30) 5.4 (6) 60 (67) 5.4 (6) Guzman-Castro S. [ 50 ] – – – – 50 (3) 33 (2) 100 (6) – Kumar H. [ 51 ] – – – – 57 (16) 21 (6) 68 (19) – Yadav T. [ 52 ] – – 2.0 (1) – 38 (19) – 44 (22) – Meshram HS. [ 53 ] – 100 (61) 100 (61) – 67 (41) 0 (0) …”

COVID-19-Associated Fungal Infections: An Urgent Need for Alternative Therapeutic Approach?

“…Nevertheless, the incidence of mucormycosis in patients having or recovering from COVID-19 has been escalating throughout the world. Multiple CAM case reports from United States, Pakistan, Iran, Mexico and single case reports from Brazil and Chile have been published ( Khan et al, 2020 ; Monte Junior et al, 2020 ; Rabagliati et al, 2021 ; Shakir et al, 2021 ; Tabarsi et al, 2021 ; Guzmán-Castro et al, 2022 ). In Europe, CAM cases have been reported from Austria, Germany, Spain, Czech Republic, France, Italy, the Netherlands and the United Kingdom ( Hanley et al, 2020 ; Arana et al, 2021 ; Bellanger et al, 2021 ; Buil et al, 2021 ; Pasero et al, 2021 ; Zurl et al, 2021 ; Danion et al, 2022 ; Hoenigl et al, 2022 ; Seidel et al, 2022 ).…”