COVID-19–associated mucormycosis: Evidence-based critical review of an emerging infection burden during the pandemic’s second wave in India

PLoS neglected tropical diseases, Journal Year: 2021, Volume and Issue: 15(11), P. e0009921 - e0009921

Published: Nov. 18, 2021

Coronavirus Disease 2019 (COVID-19), during the second wave in early 2021, has caused devastating chaos India. As daily infection rates rise alarmingly, number of severe cases increased dramatically. The country encountered health infrastructure inadequacy and excessive demand for hospital beds, drugs, vaccines, oxygen. Adding more burden to such a challenging situation, mucormycosis, an invasive fungal infection, seen sudden surge patients with COVID-19. rhino-orbital-cerebral form is most common type observed. In particular, approximately three-fourths them had diabetes as predisposing comorbidity received corticosteroids treat Possible mechanisms may involve immune inflammatory processes. Diabetes, when coupled COVID-19–induced systemic change, tends cause decreased immunity risk secondary infections. Since comprehensive data on this fatal opportunistic are evolving against backdrop major pandemic, prevention strategies primarily managing comorbid conditions high-risk groups. recommended treatment included surgical debridement antifungal therapy using Amphotericin B selected azoles. Several India-centric clinical guidelines have emerged rightly diagnose characterise presentation, understand pathogenesis involved, track disease course. Code Mucor one, which proposes simple but reliable staging system form. A recently been proposed, dedicated registry started. critical review, we extensively analyse recent evidence guidance COVID-19–associated mucormycosis

Language: Английский

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COVID-19-associated mucormycosis: Case report and systematic review

Travel Medicine and Infectious Disease, Journal Year: 2021, Volume and Issue: 44, P. 102148 - 102148

Published: Aug. 25, 2021

Language: Английский

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Overview on the Prevalence of Fungal Infections, Immune Response, and Microbiome Role in COVID-19 Patients

Journal of Fungi, Journal Year: 2021, Volume and Issue: 7(9), P. 720 - 720

Published: Sept. 2, 2021

Patients with severe COVID-19, such as individuals in intensive care units (ICU), are exceptionally susceptible to bacterial and fungal infections. The most prevalent infections aspergillosis candidemia. Nonetheless, other species (for instance,

Language: Английский

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Invasive Fungal Infections Complicating COVID-19: A Narrative Review

Journal of Fungi, Journal Year: 2021, Volume and Issue: 7(11), P. 921 - 921

Published: Oct. 29, 2021

Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases IFIs 58,784 involved 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is diagnostic challenge because its non-specific clinical/imaging features fact that proposed clinically algorithms do not really apply patients. Forty-seven observational studies 41 case reports have described total 478 CAPA were mainly diagnosed on basis cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia widely secondary infection undergoing prolonged hospitalisation, 401 indicate high crude mortality rates 56.1% 74.8%, respectively. often characterised by presence known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, broad-spectrum antibiotics. We also describe 3185 mucormycosis (including 1549 rhino-orbital (48.6%)), which main factor history poorly controlled diabetes mellitus (>76%). Its diagnosis involves examination tissue biopsies, treatment requires anti-fungal therapy combined aggressive surgical resection/debridement, but again high: 50.8% 16% The other severely immunocompromised show SARS-CoV-2 capable stunning host immune system: 20 Pneumocystis jirovecii pneumonia, 5 cryptococcosis, 4 histoplasmosis, 1 coccidioides infection, due Fusarium spp., Scedosporium.

Language: Английский

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Definition, diagnosis, and management of COVID-19-associated pulmonary mucormycosis: Delphi consensus statement from the Fungal Infection Study Forum and Academy of Pulmonary Sciences, India

The Lancet Infectious Diseases, Journal Year: 2022, Volume and Issue: 22(9), P. e240 - e253

Published: April 4, 2022

Language: Английский

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Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis

Journal of Fungi, Journal Year: 2021, Volume and Issue: 7(11), P. 985 - 985

Published: Nov. 18, 2021

Mucormycosis, a secondary fungal infection, gained much attention in the ongoing COVID-19 pandemic. This deadly infection has high all-cause mortality rate and imposes significant economic, epidemiological, humanistic burden on patients healthcare system. Evidence from published epidemiological studies showed varying prevalence of COVID-19-associated mucormycosis (CAM). study aims to compute pooled CAM other associated clinical outcomes. MEDLINE, Embase, Cochrane Study Register, WHO databases were scanned retrieve relevant articles until August 2021. All reporting among eligible for inclusion. Two investigators independently screened against selection criteria, extracted data, performed quality assessment using JBI tool. The was primary outcome, diabetes, steroid exposure, outcomes interest. Comprehensive Meta-Analysis software version 2 used performing meta-analysis. meta-analysis comprised six with sample size 52,916 mean age 62.12 ± 9.69 years. duration onset 14.59 6.88 days after diagnosis. (seven cases per 1000 patients) 50 times higher than highest recorded background (0.14 patients). A found 29.6% (95% CI: 17.2-45.9%). Optimal glycemic control judicious use steroids should be approach tackling rising cases.

Language: Английский

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Surge of mucormycosis during the COVID-19 pandemic

Travel Medicine and Infectious Disease, Journal Year: 2023, Volume and Issue: 52, P. 102557 - 102557

Published: Feb. 20, 2023

Patients with respiratory viral infections are more likely to develop co-infections leading increased fatality. Mucormycosis is an epidemic amidst the COVID-19 pandemic that conveys a 'double threat' global health fraternity. caused by Mucorales group of fungi and exhibits acute angioinvasion generally in immunocompromised patients. The most familiar foci sinuses (39%), lungs (24%), skin tissues (19%) where overall dissemination occurs 23% cases. mortality rate case disseminated mucormycosis found be 96%. Symptoms mostly nonspecific often resemble other common bacterial or fungal infections. Currently, COVID-19-associated (CAM) being reported from number countries such as USA, Turkey, France, Mexico, Iran, Austria, UK, Brazil, Italy, while India hotspot for this deadly co-infection, accounting approximately 28,252 cases up June 8, 2021. It strikes patients within 12-18 days after recovery, nearly 80% require surgery. Nevertheless, can reach 94% if diagnosis delayed remains untreated. Sometimes sole predisposing factor CAM. Therefore, study may provide comprehensive resource clinicians researchers dealing infections, intending link potential translational knowledge prospective therapeutic challenges counter opportunistic pathogen.

Language: Английский

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Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

International Forum of Allergy & Rhinology, Journal Year: 2023, Volume and Issue: 13(9), P. 1615 - 1714

Published: Jan. 21, 2023

Abstract Background Acute invasive fungal sinusitis (AIFS) is an aggressive disease that requires prompt diagnosis and multidisciplinary treatment given its rapid progression. However, there currently no consensus on diagnosis, prognosis, management strategies for AIFS, with multiple modalities routinely employed. The purpose of this multi‐institutional evidence‐based review recommendations (EBRR) to thoroughly the literature summarize existing evidence, provide AIFS. Methods PubMed, EMBASE, Cochrane databases were systematically reviewed from inception through January 2022. Studies evaluating orbital, non‐sinonasal head neck, intracranial manifestations AIFS included. An iterative process was utilized in accordance EBRR guidelines. Levels evidence principles generated. Results A evaluation published performed 12 topics surrounding (signs symptoms, laboratory microbiology diagnostics, endoscopy, imaging, pathology, surgery, medical therapy, extrasinus extension, reversing immunosuppression, outcomes survival). aggregate quality varied across domains. Conclusion Based available judicious utilization a combination history physical examination, histopathologic techniques, endoscopy cornerstone accurate In addition, optimally managed by team via surgery (including resection whenever possible), antifungal correcting sources immunosuppression. Higher (i.e., prospective) studies are needed better define roles each modality determine algorithms.

Language: Английский

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COVID-19 Associated Mucormycosis: A Systematic Review from Diagnostic Challenges to Management

Diseases, Journal Year: 2021, Volume and Issue: 9(4), P. 65 - 65

Published: Sept. 22, 2021

The coronavirus disease 2019 (COVID-19) outbreak has caused significant destruction, claiming over three million lives worldwide. Post SARS-COV-2 invasion, immunosuppression with hyperglycemia and elevated ferritin levels along steroidal treatment creates a perfect storm for opportunistic infections. There is increasing evidence of mucormycosis co-infection in COVID-19 patients, during or post-treatment. A worse prognosis, late diagnosis, limited guidelines screening management associated have made healthcare professionals fear an epidemic alongside pandemic. This review geographically reports cases (CAM), evaluates characteristics, clinical manifestations, outcomes active recovered patients. It further describes preventive strategies recommendations optimal therapy that can be adopted worldwide to curtail impending threat the system.

Language: Английский

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COVID-19–Associated Rhino-Orbital-Cerebral Mucormycosis

Indian Journal of Pharmacology, Journal Year: 2021, Volume and Issue: 53(6), P. 499 - 510

Published: Nov. 1, 2021

BACKGROUND: Till now, no meta-analysis is available to address the clinical profile, risk factors, different interventions, and outcomes among COVID-19–associated rhino-orbito-cerebral mucormycosis (C-ROCM) cases. MATERIALS AND METHODS: Eight literature databases were screened using appropriate keywords from November 1, 2019, June 30, 2021. The objectives analyze microbiological factor/comorbidity, intervention, outcome. “R-metafor package” was used for analysis. RESULTS: A total of 23 studies included. mean age presentation C-ROCM 54.6 years. most common ptosis (72.7%), lid edema (60.6%), proptosis ophthalmoplegia (57.3%), loss vision (53.7%), facial (34.7%), nasal-blockage (11.8%). Evidence intracranial spread seen in 42.8% Rhizopus fungus (57.1%) isolated fungal culture. Among patients, diabetes commonest comorbid condition, use corticosteroids related COVID-19 treatment factor (85.75%). Compared controlled diabetics, significantly higher uncontrolled diabetics (odds ratio [OR] 0.15, 95% confidence interval [C.I.] 0.041–0.544, P = 0.0010). However, significant association between severity (OR 0.930, C.I. 0.212–4.087, 0.923). For treatment, amphotericin-B antifungal drug which followed by surgical options. mortality high (prevalence 0.344, 0.205–0.403) despite treatment. CONCLUSION: Although local rhino-orbito symptoms first appear, rapid extension a number Uncontrolled excessive corticosteroid factors present High index suspicion imperative (specifically patients with diabetes), routine screening may be helpful.

Language: Английский

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