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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 [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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Metadata
- 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 › Medicine › Infectious Diseases › 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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