Multicenter Epidemiologic Study of Coronavirus Disease-Associated Mucormycosis, India
Open accessAbstract
econdary infections are known to complicate the clinical course of coronavirus disease .Bacterial infections are the most common secondary infections, but increasing reports of systemic fungal infections are causing concern.In the early part of the COVID-19 pandemic, <1% of secondary infections reported in COVID-19 patients were fungal (1,2).Preexisting conditions, indiscriminate use of antimicrobial and glucocorticoid drugs, and lapses in infection control practices are putative factors contributing to the emergence of systemic fungal infections in severe COVID-19 cases (3).After incidence of candidemia and invasive aspergillosis in COVID-19 patients increased (4,5), awareness of possible fungal co-infections increased among clinicians and microbiologists.One study reported invasive fungal infections in ≈6% of hospitalized COVID-19 patients (6).Occasional reports of COVID-19-associated mucormycosis (CAM) from various centers (7,8) and a series of 18 cases from a city in South India increased our concerns about CAM (9).India has a high burden of mucormycosis among patients with uncontrolled diabetes mellitus, and many severe COVID-19 patients have diabetes (8,10).India also is one of the countries worst affected by the COVID-19 pandemic.Thus, we would expect India to have many CAM cases.We conducted a nationwide multicenter study to evaluate the epidemiology and outcomes of CAM and compare the results with cases of mucormycosis unrelated to COVID-19 (non-CAM).
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In India, a steep increase of mucormycosis cases was observed during the COVID-19 pandemic, driven by specific immunological mechanisms, overuse of systemic corticosteroids, and an increase in the population with undiagnosed or uncontrolled diabetes.
“In India, a steep increase of mucormycosis cases was observed during the COVID-19 pandemic [88,89], driven by specific immunological mechanisms that predispose COVID-19 patients to mucormycosis [87], as well as overuse of systemic corticosteroids and an increase in the population with undiagnosed or uncontrolled diabetes [88].”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [89]
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Self-citationCOVID-19 and Fungal infections: a double debacle
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The Impact of Coronavirus Disease 2019 on Viral, Bacterial, and Fungal Respiratory Infections
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Recent Developments in the Diagnosis of Mucormycosis
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Isolated tracheobronchial mucormycosis: Report of a case and systematic review of literature
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COVID-19 and Plethora of Fungal Infections
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Mucormycosis, Past and Present: A Comprehensive Review
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Mucormycosis and COVID-19-Associated Mucormycosis: Insights of a Deadly but Neglected Mycosis
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Mucormycosis and COVID-19 an epidemic in a pandemic?
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COVID-19 associated mucormycosis: A Descriptive Multisite Study from India
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COVID-19-Associated Pulmonary Mucormycosis
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Rhizopus homothallicus: An emerging pathogen in era of COVID-19 associated mucormycosis
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The recent mucormycosis storm over Indian sky
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- Authors
- Patel, A., Agarwal, R., Rudramurthy, S. M., Shevkani, M., Xess, I., Sharma, R., Savio, J., Sethuraman, N., Madan, S., Shastri, P., Thangaraju, D., Marak, R., Tadepalli, K., Savaj, P., Sunavala, A., Gupta, N., Singhal, T., Muthu, V., Chakrabarti, A., & Network3, M.
- Affiliations
- Sterling Hospitals (IN)
- Medanta The Medicity (IN)
- Corresponding author
- Chakrabarti, Arunaloke
- ORCID
- Venue
- Emerging Infectious Diseases
- Published
- 2021-09
- Volume
- 27
- Issue
- 9
- Pages
- 2349-2359
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- PMC
- PMC8386807
- OpenAlex
- W3164172839
- Cited by
- 479
- References
- 30
- Citations by year
- 2026: 26 · 2025: 35 · 2024: 60 · 2023: 114 · 2022: 163 · 2021: 81
- FWCI
- 33.10
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Veterinary › Small Animals › Infectious Diseases and Mycology
- Keywords
- COVID-19-associated mucormycosis, mucormycosis, SARS-CoV-2, secondary fungal infection, invasive fungal infections, clinical outcomes, diabetes mellitus, glucocorticoid use
- MeSH terms
- COVID-19, SARS-CoV-2, Antifungal Agents, Humans, India, Mucormycosis, Retrospective Studies, Pandemics
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