COVID-19 associated mucormycosis: Staging and management recommendations (Report of a multi-disciplinary expert committee)

Hardeep Singh Malhotra; Prashant Gupta; Divya Mehrotra; Himanshu Dandu; Neera Kohli; Veerendra Verma; Apjit Kaur; Neeraj Kumar; Vikas Prabhu; Manish Kumar Singh; Riddhi Jaiswal; Brijesh Mishra; Bal Krishna Ojha; Nitin Dutt Bhardwaj; Virendra Atam; Bipin Puri

doi:10.1016/j.jobcr.2021.08.001

COVID-19 associated mucormycosis: Staging and management recommendations (Report of a multi-disciplinary expert committee)

J Oral Biol Craniofac Res. 2021 Oct-Dec;11(4):569-580. doi: 10.1016/j.jobcr.2021.08.001. Epub 2021 Aug 11.

Authors

Hardeep Singh Malhotra¹, Prashant Gupta², Divya Mehrotra³, Himanshu Dandu⁴, Neera Kohli⁵, Veerendra Verma⁶, Apjit Kaur⁷, Neeraj Kumar¹, Vikas Prabhu¹, Manish Kumar Singh⁸, Riddhi Jaiswal⁹, Brijesh Mishra¹⁰, Bal Krishna Ojha¹¹, Nitin Dutt Bhardwaj¹², Virendra Atam¹³, Bipin Puri¹⁴

Affiliations

¹ Department of Neurology, King George's Medical University, U.P, Lucknow, 226003, India.
² Department of Microbiology, King George's Medical University, U.P, Lucknow, 226003, India.
³ Oral and Maxillofacial Surgery, King George's Medical University, U.P, Lucknow, 226003, India.
⁴ Department of Infectious Diseases, King George's Medical University, U.P, Lucknow, 226003, India.
⁵ Department of Radiodiagnosis, King George's Medical University, U.P, Lucknow, 226003, India.
⁶ Department of Otorhinolaryngology, King George's Medical University, U.P, Lucknow, 226003, India.
⁷ Department of Ophthalmology, King George's Medical University, U.P, Lucknow, 226003, India.
⁸ Department of Anaesthesiology, King George's Medical University, U.P, Lucknow, 226003, India.
⁹ Department of Pathology, King George's Medical University, U.P, Lucknow, 226003, India.
¹⁰ Department of Plastic and Reconstructive Surgery, King George's Medical University, U.P, Lucknow, 226003, India.
¹¹ Department of Neurosurgery, King George's Medical University, U.P, Lucknow, 226003, India.
¹² Department of Hospital Administration, King George's Medical University, U.P, Lucknow, 226003, India.
¹³ Department of Medicine, King George's Medical University, U.P, Lucknow, 226003, India.
¹⁴ King George's Medical University, U.P, Lucknow, 226003, India.

Abstract

Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.

Keywords: Amphotericin; Anti-fungal; COVID-19; Mucormycosis; Rhino-orbital-cerebral mucormycosis; Staging.

Publication types

Review