COVID-19-associated mucormycosis, diabetes and steroid therapy: Experience in a single centre in Western Mexico

Mycoses. 2022 Jan;65(1):65-70. doi: 10.1111/myc.13383. Epub 2021 Oct 28.

Abstract

Background: COVID-19-associated mucormycosis (CAM) has emerged as a challenging complication as the current pandemic has increased the population requiring treatment with corticosteroids. CAM has caused a massive outbreak in India, reported to be causing cases in Iran, Egypt and The Netherlands.

Objectives: To describe CAM cases occurring in a single centre in Western Mexico.

Methods: Our group carried out a retrospective study from May 2020 to May 2021 to identify CAM cases in patients with previous COVID-19 diagnosis.

Results: Six CAM cases occurred in a single centre in Western Mexico during the study period, most of them with diabetes (n = 5/6) and all received corticosteroid therapy even when only three had severe COVID-19. After analysing local COVID-19 burden, it was estimated that in this region, CAM was 300 times more frequent among COVID individuals than the estimates for general population.

Conclusion: Similar to large reports in India and other countries, CAM cases reported in this study were diagnosed in individuals with diabetes, hyperglycaemic status and with history of previous use of corticosteroids. Identifying these individuals at risk can help the early identification of CAM. In addition, strict glycaemic control and avoidance of unnecessary corticosteroid in non-severe COVID-19 cases could help in preventing this complicated fungal infection.

Keywords: CAM; COVID-19; ROCM; SARS-CoV-2; corticosteroids; diabetes; infection; mucormycosis.

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Antifungal Agents / therapeutic use
  • COVID-19 Drug Treatment*
  • COVID-19 Testing
  • COVID-19* / complications
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / epidemiology
  • Humans
  • Mexico / epidemiology
  • Mucormycosis* / diagnosis
  • Mucormycosis* / drug therapy
  • Mucormycosis* / epidemiology
  • Retrospective Studies
  • Steroids

Substances

  • Adrenal Cortex Hormones
  • Antifungal Agents
  • Steroids