Mamata Kamat*, Uma Datar, Sanjay Byakodi, Sharad Kamat, Varsha VK
Kamat et al. J Clin Transl Res 2022; 8(1):3
Published online first: January 3, 2022
Abstract
Background and Aim: With the second wave of COVID-19, there has been a substantial rise in opportunistic infections like Mucormycosis. Mucormycosis is a fatal fungal infection and understanding the associated risk factors and their management plays a vital role to reduce mortality and morbidity caused due to such infections. This systematic review was conducted to assess the risk factors, clinical characteristics, and to understand the pathogenesis of COVID-19 Associated Mucormycosis (CAM) affecting the Head and Neck region.
Methods: The PubMed database was searched with the keywords; ((Mucormycosis) OR (invasive fungal sinusitis)) AND (COVID-19) and the PRISMA chart was prepared for the selection of the reports based on the inclusion and exclusion criteria.
Results: A total of 261 cases of CAM affecting the Head and Neck region were analyzed in this systematic review. Most of the patients presented with rhino-orbital/rhino-orbito-cerebral form of mucormycosis (ROM/ROCM). Pulmonary mucormycosis along with rhino-orbital form, involvement of hard palate, and maxillary sinus was seen in one case each. A total of 224(85.8%) patients were diabetic, 68(30.3%) of them had poor glycaemic control. Steroids were administered in 210 (80.4%) patients. Except for two, antifungal treatment was given to all patients. Follow-up data revealed 67(25.6%) deaths and 193(73.9%) were alive with 1 patient lost during follow-up.
Conclusion: The findings of this systematic review suggested that the occurrence of Mucormycosis in COVID-19 patients is related to the inherent effects of COVID-19 infection on the immune system, co-morbidities especially diabetes, and treatment aspects. Hence, a detailed understanding of these factors may aid in the personalized management of CAM and improve the disease outcome.
Relevance for Patients: The risk factors in patients affected by COVID-19 associated mucormycosis should be recognized and closely monitored in post-COVID-19 patients. A multidisciplinary team must be in place to reduce the mortality and morbidity in such patients.
DOI: http://dx.doi.org/10.18053/jctres.08.202201.003
Author affiliation
1. Department of Oral and Maxillofacial Pathology, BV(DU) Dental College and Hospital, Sangli, Maharashtra, India
2. Department of Conservative Dentistry and Endodontics, BV(DU) Dental College and Hospital, Sangli, Maharashtra, India
3. Department of Oral and Maxillofacial Pathology, RajaRajeswari Dental College and Hospital, Bengaluru, Karnataka, India
*Corresponding author:
Mamata Kamat
Department of Oral and Maxillofacial Pathology, BV(DU) Dental College and Hospital, Sangli, Maharashtra, India-416416
Email: kmamata@yahoo.com
Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China
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