Unnecessary Use of Corticosteroids for managing early mild symptoms of COVID-19 may lead to Rhino-ortibal-cerebral mucormycosis in Patients with Diabetes – a case series from Lahore, Pakistan DOI Creative Commons
Somia Iqtadar,

Masooma Hashmat,

Muhammad Nabeel Akbar Chaudhry

et al.

Therapeutic Advances in Infectious Disease, Journal Year: 2022, Volume and Issue: 9, P. 204993612210974 - 204993612210974

Published: Jan. 1, 2022

Rhino-orbital-cerebral mucormycosis (ROCM), a rare but fatal fungal infection, has recently emerged as serious complication after corticosteroids therapy in COVID-19 patients, predominantly diabetic and immunocompromised patients. The World Health Organization (WHO) current guidelines recommend administration hospitalized patients requiring supplementary oxygen or mechanical ventilation. Herein, we report case series of seven with COVID-19; three mild, moderate, one severe, from Lahore, Pakistan; all were using for managing their early mild symptoms at home around 2–3 weeks without physician’s advise, presented, admitted ROCM to Mayo hospital, March June 2021. Out the five had uncontrolled diabetes mellitus (DM) comorbidity. Eye pain, facial swelling nasal blockage, black coloration eyes, on palate, oral mucosa presenting complaints time admission. All radiographic imaging, including computed tomography (CT), paranasal sinuses (PNS), brain magnetic resonance imaging (MRI) carried out which confirmed mucosal thickening adjacent sinus bony erosions intracranial extension. treated local debridement infected necrotic tissue along intravenous liposomal Amphotericin B Posaconazole depending case. Due timely management, six prognosis was good due diagnosis treatment, while patient severe illness deteriorated died. misuse other can lead ROCM, further increase risk developing mortality. It is stressed that only recommended therapeutic advice should be followed self-isolation avoid unnecessary use corticosteroids. This also emphasizes need more vigilant monitoring high suspicion treatment invasive infection. Early management reduce morbidity

Language: Английский

COVID-19-associated fungal infections DOI Open Access
Martin Hoenigl, Danila Seidel, Rosanne Sprute

et al.

Nature Microbiology, Journal Year: 2022, Volume and Issue: 7(8), P. 1127 - 1140

Published: Aug. 2, 2022

Language: Английский

Citations

343
Multicenter Case–Control Study of COVID-19–Associated Mucormycosis Outbreak, India DOI Creative Commons
Valliappan Muthu, Ritesh Agarwal, Shivaprakash M. Rudramurthy

et al.

Emerging infectious diseases, Journal Year: 2023, Volume and Issue: 29(1), P. 8 - 19

Published: Jan. 1, 2023

Abstract We performed a case–control study across 25 hospitals in India for the period of January–June 2021 to evaluate reasons an COVID-19–associated mucormycosis (CAM) outbreak. investigated whether COVID-19 treatment practices (glucocorticoids, zinc, tocilizumab, and others) were associated with CAM. included 1,733 cases CAM 3,911 age-matched controls. found cumulative glucocorticoid dose (odds ratio [OR] 1.006, 95% CI 1.004–1.007) zinc supplementation (OR 2.76, 2.24–3.40), along elevated C-reactive protein 1.004, 1.002–1.006), host factors (renal transplantation [OR 7.58, 3.31–17.40], diabetes mellitus 6.72, 5.45–8.28], diabetic ketoacidosis during 4.41, 2.03–9.60]), rural residence 2.88, 2.12–3.79), significantly Mortality rate at 12 weeks was 32.2% (473/1,471). emphasize judicious use therapies optimal glycemic control prevent

Language: Английский

Citations

47
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 DOI
Valliappan Muthu, Ritesh Agarwal, Atul Patel

et al.

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

Published: April 4, 2022

Language: Английский

Citations

68
What Is New in Pulmonary Mucormycosis? DOI Creative Commons
François Danion, Anne Coste,

Coralie Le Hyaric

et al.

Journal of Fungi, Journal Year: 2023, Volume and Issue: 9(3), P. 307 - 307

Published: Feb. 28, 2023

Mucormycosis is a rare but life-threatening fungal infection due to molds of the order Mucorales. The incidence has been increasing over recent decades. Worldwide, pulmonary mucormycosis (PM) presents in lungs, which are third main location for after rhino-orbito-cerebral (ROC) areas and skin. risk factors PM include hematological malignancies solid organ transplantation, whereas ROC infections classically favored by diabetes mellitus. differences between locations possibly explained activation different mammalian receptors—GRP78 nasal epithelial cells integrin β1 alveolar cells—in response Alveolar macrophages neutrophils play key role host defense against diagnosis relies on CT scans, cultures, PCR tests, histology. reversed halo sign an early, very suggestive, neutropenic patients. Recently, serum test showed encouraging performance follow-up mucormycosis. Liposomal amphotericin B drug choice first-line therapy, together with correction underlying disease surgery when feasible. After stable or partial response, step-down treatment includes oral isavuconazole posaconazole delayed release tablets until complete achieved. Secondary prophylaxis should be discussed there any relapse, such as persistence neutropenia prolonged use high-dose immunosuppressive therapy. Despite these novelties, mortality rate from remains higher than 50%. Therefore, future research must define place combination therapy adjunctive treatments, while development new treatments necessary.

Language: Английский

Citations

28
Results from a national survey on COVID‐19‐associated mucormycosis in Germany: 13 patients from six tertiary hospitals DOI Creative Commons
Danila Seidel, Michaela Simon, Rosanne Sprute

et al.

Mycoses, Journal Year: 2021, Volume and Issue: 65(1), P. 103 - 109

Published: Oct. 20, 2021

Most COVID-19-associated mucormycosis (CAM) cases are reported from India and neighbouring countries. Anecdotally Europe have been presented.To estimate the disease burden describe clinical presentation of CAM in Germany.We identified through German mycology networks scientific societies, collected anonymised information via FungiScope®.We 13 six tertiary referral hospitals diagnosed between March 2020 June 2021. Twelve patients had severe or critical COVID-19, eleven were mechanically ventilated for a median 8 days (range 1-27 days) before diagnosis CAM. Eleven received systemic corticosteroids. Additional underlying medical conditions all but one patient, five immunocompromised because malignancy organ transplantation, three diabetic. developed pneumonia. Mortality was 53.8% with time to death 9 0-214 despite treatment liposomal amphotericin B and/or isavuconazole 10 cases. prevalence amongst hospitalised COVID-19 overall (0.67% 0.58% two centres) those admitted intensive care unit (ICU) (1.47%, 1.78% 0.15% significantly higher compared non-COVID-19 (P < .001 respective comparisons).COVID-19-associated is rare Germany, mostly comorbidities impaired immune system treated ICU high mortality mainly rhino-orbito-cerebral mild India. Risk than other patients.

Language: Английский

Citations

51
Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis DOI Open Access
Atsuyuki Watanabe, Matsuo So, Hayato Mitaka

et al.

Mycopathologia, Journal Year: 2022, Volume and Issue: 187(2-3), P. 271 - 289

Published: March 21, 2022

Language: Английский

Citations

31
Risk factors, mortality, and predictors of survival in COVID-19-associated pulmonary mucormycosis: a multicentre retrospective study from India DOI Creative Commons
Valliappan Muthu, Ritesh Agarwal, Shivaprakash M. Rudramurthy

et al.

Clinical Microbiology and Infection, Journal Year: 2023, Volume and Issue: 30(3), P. 368 - 374

Published: Dec. 9, 2023

Language: Английский

Citations

17
Mucormycosis in the COVID-19 Environment: A Multifaceted Complication DOI Creative Commons
Rohit Sharma, Praveen Kumar, Abdur Rauf

et al.

Frontiers in Cellular and Infection Microbiology, Journal Year: 2022, Volume and Issue: 12

Published: July 18, 2022

The second wave of coronavirus disease 2019 (COVID-19) caused severe infections with high mortality. An increase in the cases COVID-19-associated mucormycosis (CAM) was reported predominantly India. Commonly present immunocompromised individuals, is often a life-threatening condition. Confounding factors and molecular mechanisms associated CAM are still not well understood, there need for careful research this direction. In review, brief account diagnosis, management, advancement drug discovery has been provided. Here, we summarize major that dictate occurrence COVID-19 patients through analysis published literature case reports. Major predisposing to appear be uncontrolled diabetes, steroid therapy, certain cancers. At level, increased levels iron might contribute mucormycosis. We have also discussed potential role regulation metabolism establishing fungal growth. Other including diabetes prevalence spore burden India as contributing discussed.

Language: Английский

Citations

26
COVID-19 associated mold infections: Review of COVID-19 associated pulmonary aspergillosis and mucormycosis DOI Creative Commons
Shiang‐Fen Huang, Alice Ying-Jung Wu, Susan Shin‐Jung Lee

et al.

Journal of Microbiology Immunology and Infection, Journal Year: 2022, Volume and Issue: 56(3), P. 442 - 454

Published: Dec. 15, 2022

COVID-19-associated mold infection (CAMI) is defined as development of infections in COVID-19 patients. Co-pathogenesis viral and fungal include the disruption tissue barrier following SARS CoV-2 with damage alveolar space, respiratory epithelium endothelium injury overwhelming inflammation immune dysregulation during severe COVID-19. Other predisposing risk factors permissive to administration modulators such corticosteroids IL-6 antagonist. pulmonary aspergillosis (CAPA) mucormycosis (CAM) increasingly reported pandemic. CAPA usually developed within first month COVID infection, CAM frequently arose 10-15 days post diagnosis Diagnosis challenging often indistinguishable cytokine storm COVID-19, several diagnostic criteria have been proposed. Development associated a high mortality despiteappropriate anti-mold therapy. Both isavuconazole amphotericin B can be used for treatment CAM; voriconazole primary agent posaconazole an alternative CAM. Aggressive surgery recommended improve patient survival. A index suspicion timely appropriate crucial outcome.

Language: Английский

Citations

26
Recent Developments in the Diagnosis of Mucormycosis DOI Creative Commons
Éric Dannaoui

Journal of Fungi, Journal Year: 2022, Volume and Issue: 8(5), P. 457 - 457

Published: April 28, 2022

Mucormycosis is a potentially fatal infection that presents in different clinical forms and occurs patients with various risk factors. Recently, the COVID-19 epidemic has been responsible for an increase incidence of mucormycosis, particularly India. As other invasive filamentous fungal infections, there are no specific or radiological signs, we have fewer diagnostic tools available than infections. Therefore, diagnosis remains difficult. Nevertheless, optimal management, early accurate important. According to latest recommendations, based on direct examination specimens, and/or histopathology, culture. There also molecular detection from but these techniques moderately recommended. The main problems that, until now, they were not very well standardized; was great heterogeneity DNA targets methods, which resulted variable sensitivity. It this field most advances made last two years. Indeed, recent studies evaluated performance kinetics Mucorales qPCR serum shown good sensitivity specificity. Large inter-laboratory evaluations performed demonstrated qualitative quantitative reproducibility. These new results suggest use as part strategy mucormycosis. One way achieve better reproducibility could be commercial methods. Currently, at least three qPCRs (MucorGenius PathoNostics, MycoGenie Ademtech, Fungiplex Bruker) can used test serum, respiratory samples, biopsies. However, date, little evaluation Overall, PCR tissue promising its addition tool definitions mucormycosis should discussed.

Language: Английский

Citations

23