tetano
Editor, Senior Moderator
Emerg Infect Dis
. 2021 Jun 4;27(9).
doi: 10.3201/eid2709.210934. Online ahead of print.
Multicenter Epidemiologic Study of Coronavirus Disease-Associated Mucormycosis, India
Atul Patel, Ritesh Agarwal, Shivaprakash M Rudramurthy, Manoj Shevkani, Immaculata Xess, Ratna Sharma, Jayanthi Savio, Nandini Sethuraman, Surabhi Madan, Prakash Shastri, Deepak Thangaraju, Rungmei Marak, Karuna Tadepalli, Pratik Savaj, Ayesha Sunavala, Neha Gupta, Tanu Singhal, Valliappan Muthu, Arunaloke Chakrabarti, MucoCovi Network3
Abstract
During September-December 2020, we conducted a multicenter retrospective study across India to compare epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use.
Keywords: COVID-19; India; SARS; SARS-CoV-2; amphotericin; coronavirus; coronavirus disease; diabetes; epidemiology; fungi; isavuconazole; mucormycosis; posaconazole; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.
. 2021 Jun 4;27(9).
doi: 10.3201/eid2709.210934. Online ahead of print.
Multicenter Epidemiologic Study of Coronavirus Disease-Associated Mucormycosis, India
Atul Patel, Ritesh Agarwal, Shivaprakash M Rudramurthy, Manoj Shevkani, Immaculata Xess, Ratna Sharma, Jayanthi Savio, Nandini Sethuraman, Surabhi Madan, Prakash Shastri, Deepak Thangaraju, Rungmei Marak, Karuna Tadepalli, Pratik Savaj, Ayesha Sunavala, Neha Gupta, Tanu Singhal, Valliappan Muthu, Arunaloke Chakrabarti, MucoCovi Network3
- PMID: 34087089
- DOI: 10.3201/eid2709.210934
Abstract
During September-December 2020, we conducted a multicenter retrospective study across India to compare epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use.
Keywords: COVID-19; India; SARS; SARS-CoV-2; amphotericin; coronavirus; coronavirus disease; diabetes; epidemiology; fungi; isavuconazole; mucormycosis; posaconazole; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.