Recently, mucormycosis, extremely rare fungal infections are emerging as a matter of concern in COVID-19. The saprophytic fungi of Mucorales species cause the disease, Mucormycosis, only in immunocompromised hosts. Clinical presentation of mucormycosis is related to the underlying conditions; rhino-cerebral disease is the most common form, especially in patients with diabetes mellitus; pulmonary, cutaneous, or gastrointestinal infections can also occur. Severe COVID-19 itself is a life-threatening disease and various factors, including diabetes, especially when complicated by ketoacidosis, previous respiratory pathology, immunosuppressive therapy, nosocomial infection sources and systemic immune alterations of COVID-19 itself predispose to mucormycosis. No specific biomarkers are available to diagnose mucormycosis; imaging of the involved area and histopathological examination of the biopsied tissue are most important in diagnosis. The underlying medical conditions must be corrected; these include good glycemic control, tapering of steroids, and reducing or stopping immunosuppressive medications. Systemic antifungal therapy with liposomal Amphotericin B is the medical treatment of choice though drug resistance is not uncommon. Surgical debridement of devitalized tissue is often required. Severe COVID-19 patients with secondary co-infections require longer hospitalization and had higher risks of death. The mortality rate is almost 50% despite timely adequate treatment. The judicious use of systemic glucocorticoids and immunosuppressive agents for treating severe disease and hyperglycemia control seems vital for preventing and managing mucormycosis.
Mucormycosis, The Deadly New Worry to COVID-19 Pandemic.