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Diabetes Metab Syndr . Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India

tetano

Editor, Senior Moderator
Diabetes Metab Syndr


. 2021 May 21;15(4):102146.
doi: 10.1016/j.dsx.2021.05.019. Online ahead of print.
Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India


Awadhesh Kumar Singh[SUP] 1 [/SUP], Ritu Singh[SUP] 2 [/SUP], Shashank R Joshi[SUP] 3 [/SUP], Anoop Misra[SUP] 4 [/SUP]



Affiliations

Abstract

Background and aims: There are increasing case reports of rhino-orbital mucormycosis in people with coronavirus disease 2019 (COVID-19), especially from India. Diabetes mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. We aim to conduct a systematic review of literature to find out the patient's characteristics having mucormycosis and COVID-19.
Methods: We searched the electronic database of PubMed and Google Scholar from inception until May 13, 2021 using keywords. We retrieved all the granular details of case reports/series of patients with mucormycosis, and COVID-19 reported world-wide. Subsequently we analyzed the patient characteristics, associated comorbidities, location of mucormycosis, use of steroids and its outcome in people with COVID-19.
Results: Overall, 101 cases of mucormycosis in people with COVID-19 have been reported, of which 82 cases were from India and 19 from the rest of the world. Mucormycosis was predominantly seen in males (78.9%), both in people who were active (59.4%) or recovered (40.6%) from COVID-19. Pre-existing diabetes mellitus (DM) was present in 80% of cases, while concomitant diabetic ketoacidosis (DKA) was present in 14.9%. Corticosteroid intake for the treatment of COVID-19 was recorded in 76.3% of cases. Mucormycosis involving nose and sinuses (88.9%) was most common followed by rhino-orbital (56.7%). Mortality was noted in 30.7% of the cases.
Conclusion: An unholy trinity of diabetes, rampant use of corticosteroid in a background of COVID-19 appears to increase mucormycosis. All efforts should be made to maintain optimal glucose and only judicious use of corticosteroids in patients with COVID-19.

Keywords: COVID-19; Corticosteroids; Diabetes mellitus; Mucormycosis; Systematic review.
 
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