Decoding the potential link between Covid-19 and mucormycosis: Literature review

Autores

S Mounika Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India. http://orcid.org/0000-0002-5151-2810
V Vasanthi Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India. http://orcid.org/0000-0001-9710-7469
Bose Divya Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India. http://orcid.org/0000-0003-0797-4994
Madhu Narayan Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India. http://orcid.org/0000-0003-2560-6933
A Ramesh Kumar Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India. http://orcid.org/0000-0001-5158-1579
K Rajkumar Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India. http://orcid.org/0000-0002-6875-0663

Palavras-chave:

Mortality, Risk factors, Diabetes mellitus, Steroids, COVID-19, Mucormycosis

Resumo

Background: Mucorales, the causative agent of mu-cormycosis, is a life-threatening fungal infection that pri-marily affects immunocompromised hosts. This condition is becoming more severe during the current COVID-19 pandemic. The objective is to decipher the link between mucormycosis, steroids, and the associated co-morbidities of COVID-associated mucormycosis (CAM). This study is focussed on assessing the various aspects of COVID related mucormycosis. Aim: To systematically review the reported cases of CAM, clinical presentation with steroid therapy and associated comorbidities.
Materials and Methods: MeSH terms like mucor-mycosis, diabetes, SARS-CoV-2 infection, sinus, orbit, and palate were searched in the PUBMED and Google Scholar databases, and 20 case reports and case series were identified.
Results: We found that India had the highest number of cases (60%), 55% of the infected patients were male, 65% had a history of diabetes and the associated risk factor was uncontrolled diabetes (90%). The common clinical presentation among the cases was noted to be necrosis and swelling, with 55% of the cases reported to be rhino orbital mucormycosis. In most of the cases cytological and histological examination had been performed with haematoxylin & eosin, KOH, lactophenol cotton blue, and special stains such as PAS and GMS had been used in few cases along with culture in Sabouraud dextrose agar. Regarding treatment, 85% of the cases were treated with amphotericin B and in 15% of cases a combination of amphotericin B and posaconazole was employed. The rate of mortality reported was estimated to be 25%.
Conclusion: COVID-19 infection poses a significant threat to diabetic patients, increasing their susceptibility to mucormycosis. Therefore, the careful use of steroids and routine monitoring are essential in preventing this invasive infection.

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