Five probable factors responsible for the COVID-associated mucormycosis outbreak in India

Int J Infect Dis. 2021 Sep 27;112:278-280. doi: 10.1016/j.ijid.2021.09.057. Online ahead of print.


The second wave of COVID-19 due to the delta variant (B.1.617.2) led to a rapid rise in total coronavirus and COVID-associated mucormycosis cases reported from India. Hence, our study explored the possible causes of a rapid upsurge in COVID-associated mucormycosis, which has accounted for over 70% of global cases. Factors associated with the increase in mucormycosis cases in COVID-19 patients include diabetes mellitus, steroid overdose, high iron levels, and immunosuppression, combined with other possible factors, such as unhygienic conditions, prolonged hospitalization, use of ventilators, and leaky humidifiers in oxygen cylinders. These create an ideal environment for contracting mucormycosis. However, these cases could be reduced by disseminating simple preventive measures and creating awareness among the medical society and general public of this rare and deadly contagion of COVID-associated mucormycosis. The identification of early symptoms will also help to restrict the spread of lethal fungal diseases. Furthermore, a collaborative team of surgeons, ophthalmologists, physicians, and otolaryngologists would be required in the hospital wards to accelerate surgeries on severely impacted patients.

Keywords: COVID-19; COVID-associated mucormycosis; awareness; diabetes mellitus; steroid overdose.