Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India

Abstract

We provide an overview of the epidemiology and clinical course of mucormycosis in the coronavirus disease (COVID-19) pandemic era. We conducted a retrospective chart review of 178 patients with clinical or diagnostic, endoscopically or histopathologically confirmed rhino-sino-orbital or cerebral mucormycosis after COVID-19 treatment during the second wave of COVID-19 in Pune, India. Median time to symptom onset from COVID-19 detection was 28 days. Moderate or severe COVID-19 was seen in 73% of patients and diabetes in 74.2%. A total of 52.8% received steroids. Eschar over or inside the nose was seen in 75%, but baseline clinical and laboratory parameters were mostly unremarkable. Bone penetration was present in ≈90% of cases, 30% had soft-tissue swelling of the pterygopalatine fossa and 7% had cavernous sinus thrombosis, and 60% had multifocal mucormycosis. Of the 178 study cases, 151 (85%) underwent surgical debridement. Twenty-six (15%) died, and 16 (62%) of those had multifocal mucormycosis.

Covid-19 and Rhino-Orbital Mucormycosis: What's the Link?

“…Hypoxemia due to COVID-19 and inappropriate use of glucocorticoid drugs were independently associated with development of CAM. 12 The mortality rate for CAM patients was high (33.7%) but was comparable to rates for non-CAM patients (33.3%). The mortality rate of cases reported from India (36.5%) was also less than the globally reported cases (61.9%).…”

Increasing Incidence of mucormycosis in Spanish inpatients from 1997 to 2018

“…28 Finally, it has recently been shown that the SARS-CoV2 infection is a new risk factor for mucormycosis, especially in countries with a high incidence such as India. 30 Thus, mucormycosis can occur among COVID-19 patients, especially with poor glycaemic control, widespread and injudicious use of corticosteroids and broadspectrum antibiotics, and invasive ventilation. 31 Unfortunately, it has not been possible to evaluate the impact of COVID on mucormycosis because of lack of available data in the Spanish health system during COVID-19 pandemic.…”

Rejuvenating The Shunned Art of Diagnostic Nasal Endoscopy Using Angled Endoscopes- A Descriptive Study

“…The distribution of both these markers also showed the trend of being more frequently visualized by angled endoscopes. Cases of eschar increased vehemently due to the prevalence of mucormycosis during the COVID-19 pandemic overlapping the study period [11][12] . It accounted for 4.5% of study population when investigated using a 0 degree scope.…”