4.4 Article

Emerging cases of mucormycosis under COVID-19 pandemic in India: Misuse of antibiotics

Journal

DRUG DEVELOPMENT RESEARCH
Volume 82, Issue 7, Pages 880-882

Publisher

WILEY
DOI: 10.1002/ddr.21862

Keywords

black fungus; COVID-19; mucormycosis; SARS-CoV-2; steroids

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The second wave of COVID-19 in India had a significant impact with a high number of cases and deaths. Along with that, the emerging threat of mucormycosis has been rapidly increasing in India.
COVID-19's second wave had a significant impact on India, on May 7, 2021, the largest daily recorded case count was a little more than 4 million, and it has since fallen. Although the number of new cases reported has dropped, during the third week of May 2021, India accounted for about 45% of new cases identified globally and around 34% of deaths. As India maintains its present level of stability, a new urgent threat has emerged in the form of coronavirus-associated mucormycosis. Mucormycosis, an acute and deadly fungal infection caused by Mucorales-related fungal species, is a fungal emergency with a particularly aggressive propensity for contiguous spread, associated with a poor prognosis if not properly and immediately identified, and treated. Mucormycosis, sometimes referred to as the black fungus, has increased more rapidly in India during the second wave of COVID-19 than during the first wave, with at least 14,872 cases as of May 28, 2021. Uncontrolled diabetic mellitus (DM) and other immunosuppressive diseases such as neutropenia and corticosteroid treatment have traditionally been identified as risk factors for mucormycosis. Therefore, the use of glucocorticoids or high doses of glucocorticoids in mild COVID-19 cases (without hypoxemia) should be avoided. In addition, drugs that target the immune pathway, such as tocilizumab, are not recommended without clear benefits.

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