4.5 Article

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

Journal

MYCOSES
Volume 65, Issue 1, Pages 65-70

Publisher

WILEY
DOI: 10.1111/myc.13383

Keywords

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

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This study described six cases of COVID-19-associated mucormycosis in a single center in Western Mexico, with most patients having diabetes and all receiving corticosteroid therapy. It was found that in this region, CAM was 300 times more frequent among COVID individuals than the estimates for the general population. Identifying individuals at risk and avoiding unnecessary corticosteroid use in non-severe COVID-19 cases could help prevent this complicated fungal infection.
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.

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