COVID-19 ASSOCIATED MUCORMYCOSIS: A CASE SERIES REPORT AND AN UMBRELLA REVIEW

Authors

  • C Pai Touro University College of Osteopathic Medicine, California, USA
  • S Utamsing Touro University College of Osteopathic Medicine, California
  • D Bayardorj 3rd year medical Student, Touro University College of Osteopathic Medicine, California
  • A Harugop ENT Department, Jawaharlal Nehru Medical College and Hospital, Belgavi, India
  • V Gore Ophthalmology Department, Mahatma Gandhi Mission Medical College and Hospital, Navi Mumbai, India

DOI:

https://doi.org/10.17501/26138417.2023.6109

Keywords:

Post COVID 19 Office Hybrid Work Arrangement, Employee Health, Employee Safety

Abstract

The emerging epidemic of COVID-19 Associated Mucormycosis(CAM) has been recognized as a significant global public health threat. India accounted for majority of the globally detected CAM cases especially during the second wave of the pandemic in 2021. A severe form of invasive CAM called Rhino-orbital-cerebral mucormycosis (ROCM) led to high mortality and morbidity especially in COVID patients with predisposing factors causing immunosuppression such as diabetes mellitus, malignancies, and steroid therapy. This study was carried out to describe the demographic features as well as analyze the comorbidities and outcomes of patients diagnosed with CAM and to provide an umbrella review of published global systematic reviews on CAM with special reference to ROCM. In this case series report, we have noted the findings and outcomes of 12 COVID patients with CAM treated at two different tertiary care hospitals in India. All were males, with an average age of 54.25 years. 66.6% had invasive ROCM and 91.7% had poorly controlled diabetes. All received liposomal amphotericin B, 58.3% underwent surgical interventions and the mortality rate was 33.3%.  We also conducted an umbrella review of systematic reviews reported from 2020-2022. PubMed, Embase, Scopus and Google scholar databases and the PRISMA 2020 checklist were used to refine retrieval and review based on our study criteria. Common patterns were noted regarding the predisposing factors and treatment outcomes. Good glycemic control, the regulated use of steroids, proper decontamination of oxygen cylinders and the hospital environment as well as avoidance of overzealous use of steam inhalation have been proposed as important measures to control this epidemic.

Downloads

Download data is not yet available.

Author Biography

S Utamsing, Touro University College of Osteopathic Medicine, California

2nd year, Osteopathic Medical student

References

Affinati, A., Wallia, A., & Gianchandani, R.(2021). Severe hyperglycemia and insulin resistance in patients with SARS Cov-2 infection: a report of two cases. Clin Diabetes Endocrinol, 7(1):8. https://doi.org/10.1186/S40842-021-00121-Y.78

Afzal, S., & Nasir, M. (2022). Aspergillosis and Mucormycosis in COVID-19 Patients: A Systematic Review. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 32(5), 639–645. https://doi.org/10.29271/jcpsp.2022.05.639

Ahmad, A.(2021,June 7). Over 28,200 'black fungus' cases recorded In India. Anadolu Agency-World, Asia-Pacific. https://www.aa.com.tr/en/asia-pacific/over-28-200-black-fungus-cases-recorded-in-india/2266396

Aromataris, E and Munn, Z. (2020). Chapter 1: JBI Systematic Reviews. JBI Manual for Evidence Synthesis. http://joannabriggs.org/research/critical-appraisal-tools.html

Bhattacharyya, A., Sarma, P., Sharma, D. J., Das, K. K., Kaur, H., Prajapat, M.…Medhi,B. (2021). Rhino-orbital-cerebral-mucormycosis in COVID-19: A systematic review. Indian Journal of Pharmacology, 53(4), 317–327. https://doi.org/10.4103/ijp.ijp_419_21

Choudhary, O.P., Singh, P. I., & Rodriguez-Morales, A.J.(2021). Second wave of COVID-19 in India: Dissection of the causes and lessons learnt. Travel Med Infect Dis. 43:102126. doi:

1016/j.tmaid.2021.102126. Epub 2021 Jun 16. PMID: 34144178; PMCID: PMC8214078.

Cornely, O. A., Alastruey-Izquierdo, A., Arenz, D., Chen, S. C. A., Dannaoui, E., Hochhegger, B., … and Arikan-Akdagli, S. Mucormycosis ECMM MSG Global Guideline Writing Group (2019). Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. The Lancet. Infectious diseases, 19(12), e405–e421. https://doi.org/10.1016/S1473-3099(19)30312-3

Donovan, M. R., Miglani, A., Lal, D., & Marino, M. J. (2022). Factors associated with invasive fungal sinusitis in patients with COVID-19: A systematic review and single-center case series. Laryngoscope Investigative Otolaryngology, 7(4), 913–919. https://doi.org/10.1002/lio2.833.

Dulski, T.M., DeLong, M., Garner, K., Patil, N., Cima, M.,J., Rothfeldt, L. … and Kothari, A. (2021). Notes from the Field: COVID-19–Associated Mucormycosis -Arkansas, July–September 2021. MMWR Morb Mortal Wkly Rep;70:1750–1751. DOI http://dx.doi.org/10.15585/mmwr.mm7050a3

Greenberg, R.N., Scott, L.J., Vaughn, H.H., & Ribes, J.A. (2004). Zygomycosis (mucormycosis): emerging clinical importance and new treatments. Curr Opin Infect Dis.17(6):517.

Hariprasath,P., & Chakrabarti, A. (2019). Global Epidemiology of Mucormycosis. Journal of fungi (Basel, Switzerland), 5(1), 26. https://doi.org/10.3390/jof5010026

Hoenigl, M., Seidel, D., Carvalho, A., Rudramurthy, S.M., Arastehfar, A., Gangneux J.P.,… and Chakrabarti, A.; ECMM and ISHAM collaborators.(2022).The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries. The Lancet. Microbe, 3(7), e543–e552. https://doi.org/10.1016/S2666-5247(21)00237-8

Hussain, S., Riad, A., Singh, A., Klugarová, J., Antony, B., Banna, H., & Klugar, M. (2021). Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis. Journal of Fungi (Basel, Switzerland), 7(11), 985. https://doi.org/10.3390/jof7110985

Muthu, V., Rudramurthy, S. M., Chakrabarti, A., & Agarwal, R. (2021). Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World. Mycopathologia, 186(6), 739–754. https://doi.org/10.1007/s11046-021-00584-8.

Nagalli, S., & Kikkeri, N. S. (2021). Mucormycosis in COVID-19: A systematic review of literature. Le infezioni in medicina, 29(4), 504–512. https://doi.org/10.53854/liim-2904-2.

Nguyen, L. D., Viscogliosi, E., & Delhaes, L. (2015). The lung mycobiome: an emerging field of the human respiratory microbiome. Frontiers in microbiology, 6, 89. https://doi.org/10.3389/fmicb.2015.00089

Page, M.J., Moher, D., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D.…and McKenzie, J.,E.(2021). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. British Medical Journal;372:n160. doi: 10.1136/bmj.n160.

Pal, R., Singh, B., Bhadada, S. K., Banerjee, M., Bhogal, R. S., Hage, N., & Kumar, A. (2021). COVID-19-associated mucormycosis: An updated systematic review of literature. Mycoses, 64(12), 1452–1459. https://doi.org/10.1111/myc.13338

Raut, A., & Nguyen, T.H.(2021). Rising incidence of mucormycosis in patients with COVID-19: another challenge for India amidst the second wave? The Lancet Respiratory Medicine, 9(8), e77, ISSN 2213-2600. https://doi.org/10.1016/S2213-2600(21)00265-4.

RECOVERY Collaborative Group, Horby, P., Lim, W.S., Emberson, J.R., Mafham, M, Bell J.L., et al. (2021). Dexamethasone in hospitalized patients with Covid-19. N Engl J Med.;384:693–704.

Samarasekera, U. (2021). India grapples with second wave of COVID-19. The Lancet. Microbe, 2(6), e238. https://doi.org/10.1016/S2666-5247(21)00123-3.

Serris, A., Danion, F., & Lanternier, F. (2019). Disease Entities in Mucormycosis. Journal of fungi (Basel, Switzerland), 5(1), 23. https://doi.org/10.3390/jof5010023.

SeyedAlinaghi, S., Karimi, A., Barzegary, A., Pashaei, Z., Afsahi, A. M., Alilou, S.… Dadras, O.(2022). (2022). Mucormycosis infection in patients with COVID-19: A systematic review. Health Science Reports, 5(2), e529. https://doi.org/10.1002/hsr2.529

Sen, M., Lahane, S., Lahane, T. P., Parekh, R., & Honavar, S. G. (2021). Mucor in a Viral Land: A Tale of Two Pathogens. Indian Journal of Ophthalmology, 69(2), 244–252. https://doi.org/10.4103/ijo.IJO_3774_20

Soliman, S. S. M., Baldin, C., Gu, Y., Singh, S., Gebremariam, T., Swidergall, M….and Ibrahim, A. S. (2021). Mucoricin is a ricin-like toxin that is critical for the pathogenesis of mucormycosis. Nature microbiology, 6(3), 313–326. https://doi.org/10.1038/s41564-020-00837-0

Watanabe, A., So, M., Mitaka, H., Ishisaka, Y., Takagi, H., Inokuchi, R…and Kuno, T. (2022). Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis. Mycopathologia, 187(2-3), 271–289. https://doi.org/10.1007/s11046-022-00627-8

Werthman-Ehrenreich, A. (2021). Mucormycosis with orbital compartment syndrome in a patient with COVID-19. The American Journal of Emergency Medicine, 42, 264.e5–264.e8. https://doi.org/10.1016/j.ajem.2020.09.032

Zobairy, H., Salem, M. M., Ghajarzadeh, M., Mirmosayyeb, O., & Mirsalehi, M. (2022). Diabetes mellitus and other underlying conditions in patients with coronavirus disease 2019 associated rhino-orbito-cerebral mucormycosis: a systematic review and meta-analysis. The Journal of Laryngology and Otology, 136(9), 788–798. https://doi.org/10.1017/S0022215122001074

Downloads

Published

2023-07-21

How to Cite

Pai, C., Utamsing, S., Bayardorj, D., Harugop, A., & Gore, V. (2023). COVID-19 ASSOCIATED MUCORMYCOSIS: A CASE SERIES REPORT AND AN UMBRELLA REVIEW. Proceedings of the Global Public Health Conference, 6(1), 119–135. https://doi.org/10.17501/26138417.2023.6109